Hartville Migrant Ministry Medical Application
Hartville Migrant Ministry exists to serve the needs of the migrant farmworkers of Hartville, OH. Migrant workers are among the most economically disadvantaged and most medically vulnerable groups. The workers and their families benefit greatly from the programs and services provided at the Hartville Migrant Center, and we could not provide these services without the help of dedicated, high-quality medical volunteers like you. Thank you for applying to be a part of our medical team - we look forward to serving with you!
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Name: *
Referred by (if applicable):
Email: *
Phone number:
Specialty: *
Current Place of Employment/Practice:
License Number:
Do you speak Spanish?
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Please indicate how often you are interested in volunteering:
I am willing to allow up to (2) medical students to gain medical experience by shadowing during my volunteer hours
Additional Questions/Comments:
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