SNEC Medical Volunteers/Professionals Registration Form
Southern New England Conference invites you to register with us below as a licensed/trained medical professional and/or individual willing to volunteer and be trained as a medical missionary. By completing this form, you are consenting to our use of your information to contact you as a volunteer for evangelistic health projects through our SDA church organization.
Email address *
First Name *
Your answer
Last Name *
Your answer
Mailing Address:
Your answer
Phone # *
Your answer
Age: *
Your answer
Are you a licensed/trained medical professional? (Please note that licensed or trained professionals will be asked to provide official documentation/license# before being permitted to provide medical treatment or advice under such title.) *
Required
What is your area of medical experience/specialty/practice? (If this does not apply please write n/a) *
Your answer
Are you a member of the Seventh-Day Adventist Church? *
Required
If you answered yes to the above question, kindly provide what SDA church you currently attend:
Your answer
State in which your church is located?
Your answer
What areas of medical missionary work are you interested in focusing as a volunteer? *
Required
Would you be willing to volunteer in some of these other non-medical capacities?
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy