November 17th, 2012 Clinic!
Hello everyone,

We will be holding our next clinic trip on Saturday, November 17th. Please note that you must have a valid US passport or green card in order to attend. We will be holding a MANDATORY pre-clinic meeting for those chosen to attend on Friday, November 16th at 6pm, and meeting on Saturday at 7am for the full day trip.

In order to provide the best opportunities for our most active members, priority is given to members who have participated in a minimum of 2 events. Please note that priority will also be given to drivers, fluent Spanish speakers, and those chosen to attend the previous cancelled clinic trip; however anyone interested is encouraged to apply.

You will receive an e-mail letting you know if you were chosen next week. Look forward to a great clinic!

Milad Bahmanof
FS Clinic Coordinator

First Name *
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Last Name *
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Phone Number *
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Email *
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Emergency Contact *
Name & Phone Number
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Can you drive to clinic on November 17th, 2012? *
Gas money will be reimbursed, no clinic fee for drivers! :)
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If you can drive, how many people (including yourself) does your vehicle hold? *
What is the make, model, and license plate number of your car? *
Ex. Toyota Camry LVG143D; This information is required for medication transport into Mexico.
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Spanish Fluency *
No Spanish
Fluent Spanish
Membership Status *
Must have paid member fees for 2012-2013 ($25) to be a member
Chosen to attend last clinic *
Any other comments
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