SEMILLA Volunteer Application
Cell phone number
What is your current status?
Mid-Level Provider (NP/PA)
If you have a current university affiliation, please name
What is your level of ability in Spanish?
If you have significant prior experience in Global Health Projects please describe
Of the following committees, please indicate your top three choices on which you would like to volunteer:
please check your top 3 choices
Resuscitation (Cardiac arrest, trauma, difficult airway, pediatric resuscitation, simulation)
Pre-hospital care (first aid, EMS development)
Emergency Medicine Specialty Development
Do you have any particular skills that are relevant to Project SEMILLA that we should know about? (Examples: grant writing, accounting, web development, photography, statistics, translation, editing). Please describe
Do you have particular interest/contacts for the development of Emergency Medicine in a country other than Nicaragua?
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