EnvisionFulbright: Trip Application
This is the Application for participation in the Timmy Global Health-led trips to provide eyeglasses to communities in need throughout Latin America. The following trips are put on by Timmy Global Health and EnvisionFulbright, a collaboration between the Fulbright Association and RestoringVision. Please email Alyssa Rossodivita, US Programs Manager at Timmy Global Health, at alyssa@timmyglobalhealth.org with questions. Applications are due by 11:59 PM PST on Sunday, March 27, 2016.

IMPORTANT NOTE ON FLIGHTS: All trips cost $1000, which includes most aspects of the trip (food, lodging, in country transportation, activities, short term medical insurance, administrative fee, 300 pairs of reading glasses, and 200 pairs of sunglasses) EXCEPT roundtrip airfare. All Dominican Republic trips fly into Santiago (STI), all Ecuador trips fly into Quito (UIO), and all Guatemala trips fly into Guatemala City (GUA).

IMPORTANT NOTE ON VISAS: Neither Timmy Global Health nor EnvisionFulbright are able to secure visas for travel; while US Citizens may travel to Ecuador, Guatemala, and the Dominican Republic without a visa, regulations vary if you hold citizenship from another country. Please review these regulations and select countries to which you are able to travel, according to your citizenship.
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First Name *
Last Name *
Primary Email *
Primary Phone Number *
What is your birthdate? *
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Fulbright Year *
Fulbright Country *
The following trips in 2016 are available. Please select which trips would you like to be considered for, based on your interests and availability. *
Select all that apply (**indicates a trip on which there is space to bring a friend, family member, or partner)
Required
Spanish Level *
In a maximum of 200 words, please describe why you would like to join this trip. Please comment on your interest in health care, Latin American culture, and/or bringing eye care to people who need it but cannot afford it. *
Please check here to show that you understand your resume/CV is required to complete your application. *
Required
Scholarship Application for Millennials
If you are a young Fulbright alumni (we'll let you self-identify), you are eligible to apply for a $1,000 scholarship covering the program fee. One $1,000 scholarship will be awarded to a young Fulbrighter who would not be able to afford the program fee on your own to attend one of the 2016 trips. The winner will be notified within a few weeks of the application deadline. Please proceed if you would like to be considered for this scholarship.
What idea(s) do you have to promote the EnvisionFulbright program through the Fulbright Association website / social media after the trip? Please be creative--we will ask the scholarship recipient to help us raise awareness for this program to bring eye care to the underserved following their trip.
Please limit your response to 100-150 words.
Please let us know if you would like to be considered for a place on a medical service trip regardless of whether you receive the $1000 scholarship.
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