Guerrero Clinic Fall 2017, Tue 9/26 - Thu 9/28
Volunteer Information
First Name
Please Enter name as it is found on your passport
Your answer
Middle Name
Please Enter name as it is found on your passport
Your answer
Last Name
Please Enter name as it is found on your passport
Your answer
Preferred First Name (If different than legal name)
Your answer
Date of Birth
MM
/
DD
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YYYY
Gender
Cell Phone Number
xxx-xxx-xxxx
Your answer
Email Address
Your answer
Citizenship
Required
Passport Issuing Country
Required if you elect for Clinic to book your airfare or will bring Instruments/Equipment
Your answer
Passport Number
Required if you elect for Clinic to book your airfare or will bring Instruments/Equipment
Your answer
Passport Expiration - Leave blank if you do not currently have a passport.
Must have a passport that expires at least 6 months after return from the clinic. You can generally get a passport quickly but it can be expensive and not guaranteed that it will arrive in time. The clinic will not refund your money if we purchase a ticket for you and your passport does not arrive in time.
MM
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DD
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YYYY
Do you have any physical limitations that will impact your ability to volunteer at the clinic?
Please keep in mind the clinic is in rural Mexico at an elevation of 7,000 ft
Do you have any dietary restrictions?
People with various restrictions successfully attend our clinic. However, we do not promise that we can accommodate all diets. Please let us know potential challenges so we can help you decide whether you can eat with us.
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