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Health & Development in Guatemala Clinical Trip Commitment Form - 2026
We are very excited to have you officially join the Emory Helps Guatemala team!
When: June 5-15, 2026
Where: Huehuetenango, Guatemala
This form will help us keep track of the members that make up this year's team and walk you through the next steps you need to take to confirm your spot.
This form will help us keep track of the members that make up this year's team and walk you through the next steps you need to take to confirm your spot.
**ONLY FILL OUT THIS FORM IF YOU ARE SURE YOU WILL BE TRAVELING WITH US**
If you have any questions feel free to reach out to Dani Farchi at (954) 488-1473 or daniela.farchi@emory.edu and we will be happy to help you.
Steps and deadlines:
*Make sure you have a valid passport until December 2026 (and visa if not a US citizen) before committing.
1. Commit to trip by filling out the application on Helps website as new/returning volunteer (Team #2916 for undergrads, Team #2906 for medical providers) by this week!
If you have any questions feel free to reach out to Dani Farchi at (954) 488-1473 or daniela.farchi@emory.edu and we will be happy to help you.
Steps and deadlines:
*Make sure you have a valid passport until December 2026 (and visa if not a US citizen) before committing.
1. Commit to trip by filling out the application on Helps website as new/returning volunteer (Team #2916 for undergrads, Team #2906 for medical providers) by this week!
https://www.helpsintl.org/apply-for-a-team/
2. Make your trip deposits on the Helps website (1st payment due March 13th; 2nd payment due April 3rd; Final Balances due April 24th). You must write your name as the beneficiary AND "on behalf of". Also make sure you are depositing to the correct team number that you are on (Team #2916 for undergrads, Team #2906 for medical providers).
3. Complete online modules (Module 1 due March 15th; Module 2 due April 12th)
2. Make your trip deposits on the Helps website (1st payment due March 13th; 2nd payment due April 3rd; Final Balances due April 24th). You must write your name as the beneficiary AND "on behalf of". Also make sure you are depositing to the correct team number that you are on (Team #2916 for undergrads, Team #2906 for medical providers).
3. Complete online modules (Module 1 due March 15th; Module 2 due April 12th)
*Before traveling there will be cultural sensitivity and ethics workshops that are mandatory for all members to attend. You will be asked to complete some online modules and readings prior to the meetings. If you are unable to attend a meeting, you will have to submit a reflection on the day's topic. By accepting your position to travel on the EHG team, you commit to completing all of these team requirements.
5. Pre-departure meeting (just need to attend one): either on May 28th at 7pm or May 31st at 4pm
Thank you all for your commitment and we can't wait for the trip!
First and last name (will be used for your nametag)
First and last name (will be used for your nametag)
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Preferred pronouns
Preferred pronouns
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Role (will be written on name tag) Ex. Pharmacist, Nurse, Education/Community Development, etc.
Role (will be written on name tag) Ex. Pharmacist, Nurse, Education/Community Development, etc.
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I am committed to traveling from June 5-15, 2026 with the EHG team.
I am committed to traveling from June 5-15, 2026 with the EHG team.
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Yes
I need flexibility with these dates.
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Describe need for flexibility with the established trip dates.
Describe need for flexibility with the established trip dates.
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I have checked that my passport is valid until AT LEAST December 2026. If not a US citizen, I have checked the visa requirements to enter Guatemala and am working on getting one if necessary.
I have checked that my passport is valid until AT LEAST December 2026. If not a US citizen, I have checked the visa requirements to enter Guatemala and am working on getting one if necessary.
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I have a valid passport through Dec. 2026
I am working on getting a visa/ have a visa
I need a new passport
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Passport Number, if not applicable put N/A
Passport Number, if not applicable put N/A
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I have filled out my application for the Emory team as a new/returning volunteer according to my status on the Helps website: https://www.helpsintl.org/apply-for-a-team/ (Team #2906 for medical providers, Team #2916 for undergraduates)
I have filled out my application for the Emory team as a new/returning volunteer according to my status on the Helps website: https://www.helpsintl.org/apply-for-a-team/ (Team #2906 for medical providers, Team #2916 for undergraduates)
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I have paid the $1,650 on the Helps website (links listed above in form description) or on the Momentum website if working through EGPA.
* You can cover the cost in installments. You can also have family and friends make donations on your behalf. You MUST ensure they note your name as the beneficiary and "on behalf of".
I have paid the $1,650 on the Helps website (links listed above in form description) or on the Momentum website if working through EGPA.
* You can cover the cost in installments. You can also have family and friends make donations on your behalf. You MUST ensure they note your name as the beneficiary and "on behalf of".
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I have paid the $1,650 on the Helps website (links listed above in form description)
I have started covering the cost of my trip
I have not started
I need financial assistance
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I commit to completing the assigned readings/modules prior to the sessions in the spring (Module 1 due March 15th; Module 2 due April 12th). I understand that not participating in a discussion will affect my standing to travel on the team.
I commit to completing the assigned readings/modules prior to the sessions in the spring (Module 1 due March 15th; Module 2 due April 12th). I understand that not participating in a discussion will affect my standing to travel on the team.
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Select the date for the Pre-departure meeting (just need to attend one)
Select the date for the Pre-departure meeting (just need to attend one)
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May 28th at 7pm
May 31st at 4pm
Cannot make it to either
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Dietary restrictions
Dietary restrictions
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Emergency Contact Name
Emergency Contact Name
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Emergency Contact Phone Number
Emergency Contact Phone Number
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Accommodations Needed
Accommodations Needed
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