The Cleft Foundation Application

Please complete the following application questions thoroughly and honestly. If you are applying as an international volunteer, you must be at least 18 years old to participate or attend the program with a chaperone. Once your application is complete, TCF will contact you with additional information. Thank you.

Email address *

Name *

Your answer

Phone Number *

Your answer

Birthday *

YYYY

School Name & Major(s)/Minor(s) *

Your answer

Impact Opportunities *

I would like to apply for the Fundraising Internship

I would like to apply to be an ALTERNATE on an international mission to Deraniyagala, Sri Lanka (March 17-23, 2017)

I would like to apply to be an ALTERNATE on an international mission to Agra, India (November 17-28, 2017)

Required

Volunteer Opportunities *

Please indicate your preference:

I would like to aid in prenatal health education

I would like to aid in vitamin and supplements dispersion

I would like to compile data, graphs, and statistics

I would like to aid in reproductive education

I would like to be a medical volunteer (only applies to health professionals)

Required

Please mark the following that apply to you:

I am comfortable around infants and small children

I am comfortable in hospitals and/or patient care

I like to be challenged outside of my comfort zone

I am able to lift heavy objects

I have experience compiling data, graphs, and statistics

I am interested in photojournalism

Language Expertise *

What language(s) do you speak? What is your skill level?

Your answer

How did you hear about The Cleft Foundation? *

Your answer

Why do you want to join The Cleft Foundation? *

Your answer

Have you partaken in any other volunteer missions abroad? If so, which ones and what did you gain from them? *

Your answer

If you are a medical professional, what qualities do you possess that will enhance the team? i.e., if you are a surgeon, is your goal to perform reconstructive surgeries? How will your knowledge and expertise contribute and compliment the goals of The Cleft Foundation?

Your answer

Medical Conditions *

Do you have any medical conditions and/or dietary restrictions that The Cleft Foundation should be aware of?

Your answer

Please list any prescribed medications you are currently taking:

Your answer

Dietary Needs *

Please list any dietary needs The Cleft Foundation should be aware of:

Your answer

Vaccines

The Cleft Foundation requires that all volunteers are current for the following vaccines and provide proof of vaccinations:

HEPATITIS A (series of 2 shots)

HEPATITIS B (series of 3 shots)

Neither.

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