Team Heart Volunteer Application

Become a Volunteer

Each year volunteers travel at their own expense and raise money to support travel and the cost of supplies in addition to their vacation time donated. For some, this might be their first year, for others, they are returning for their tenth trip. But for all involved- it is life-changing. Help us by becoming a volunteer to help save the life of a very deserving patient!

Volunteer Application

Dropdown

First

Last

Address

City

State/Province

Zip/Postal

Country

Phone

Preferred method of contact?

Phone

Qualifications

Experience

Position Applied for in Team

Date Available

Date of Birth

Passport Nationality

Passport Number

Passport Expiration Date

Next of Kin Name

Next of Kin Number

Next of Kin Address

City

State/Province

Zip/Postal

Country

Medical History and Current Treatment

Professional Registration

Current Registration Number

Current Registration State

Up-to-Date Resume

Maximum upload size: 516MB

Medical License and/or Certifications

Maximum upload size: 516MB

Original Medical or Nursing Degrees

Maximum upload size: 516MB

Personal References

Maximum upload size: 516MB

HOW TO APPLY
Include with this application an up-to-date resume, copies of your current registration, original medical or nursing degrees, if medical personnel, and personal references page. All portions of the application must be submitted in order for processing.

AGREEMENT
If selected to be a member of this team, I understand decisions are made according to the regulations set forth by the organization and in adherence with the hosting facility the best interest and safety of the team. I accept the responsibility of working as a Team Heart Member and agree to cooperate with the decisions of the Team Heart leadership and coordinators for care guidelines and scientific inquiry. There will be a non-refundable administrative fee of $100 upon acceptance to any Team Heart Medical Trip.

Electronic Signature

Date of Application

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”I consider being a part of Team Heart to be the biggest achievement in my nursing career, and one of the best parts of my life!
KRISTIN CALHENO RN

”Rwanda can eradicate rheumatic heart disease in a generation – it is an achievable goal.
DAVID WILSON

”After I returned from Rwanda, each time I passed my to do list, my pencil hovered to cross off Rwanda--I could not do it. Rwanda was not finished.
MARIA STEELMAN

”I am thankful to Team Heart for saving my life and allow me to return to my studies energetically and it does me proud to be studying public health.
TEAM HEART PATIENT

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Team Heart Volunteer Application

Become a Volunteer

Volunteer Application

Saving Young Hearts. Building Bright Futures.

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