ASCP Center for Global Health: Volunteer Interest Form
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Background Information
First Name
 *
Last Name *
Email *
Institution/Employer *
Country of Residence
What is your ASCP membership category?
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Education/Degrees
What are your professional certifications? Please check all that apply.
What are your areas of professional expertise? Please check all that apply.
Please indicate any additional competencies, skills or experience. Please check all that apply.
Do you have prior experience working in low- or lower-middle income countries?
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Do you have working proficiency in a language other than English?
Volunteer Opportunities
Please indicate which volunteer opportunities you are interested in.
Telepathology Virtual Volunteer: Virtual volunteers provide secondary consultation to pathologists in ASCP's network of telepathology laboratories around the world. Volunteers must be board-certified anatomic pathologists and commit to providing review of referred cases within 24-72 hours of submission. Are you interested in serving as a telepathology virtual volunteer? 
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In-Person Education/Training Volunteers: Topics of instruction could include bench techniques, grossing, embedding, PCR, quality management, and diagnostic case studies among others. Are you interested in traveling to serve as faculty for in-person training and education?
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Virtual Education/Training Volunteers: Are you interested in serving as faculty for online virtual educational activities?
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Curriculum Development & Instructional Design Volunteers: Are you interested in developing educational program (pre-service or in-service) for pathologists and laboratory professionals in LMICs?
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Organizational Liaison/ASCP Representative: Organizational liaisons serve as representatives of ASCP to international partners and working groups like the City Cancer Challenge (C/CAN), the International Cancer Control Partnership (ICCP), The Global Breast Cancer Initiative (GBCI) and others. Are you interested in serving as an organizational liaison or ambassador? 
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Remote Mentorship: Are you interested in being a virtual mentor for emerging laboratory leaders in LMICs?
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Please provide a personal statement describing why you are interested in international volunteer opportunities with ASCP.
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