Current Activities Advocacy FAQ Liberation Medicine Newsletters Photo Album Getting Involved Donations - Ways to Help DGH Raise Funds Supplies Needed What's New Links Search the DGH Web Site

Doctors for Global Health
Domestic Volunteer Application

Please print, fill out and mail to the address at the end.

First Name:                                                                                                          
Last Name:                                                                                                          
Birth Date:                                                                                                          
Address:                                                                                                          
City, State, Zip:                                                                                                          
Telephone:                                                                                                          
Fax:                                                                                                          
Email:                                                                                                          
Occupation:                                                                                                          
Language Abilities and Level:                                                                                                          
Occupation/Interests/Activities                                                                                                          

Are you:
    • New to DGH
    • Former International Volunteer
    • Current Volunteer
    • Advisory Council Member
    • Other                                                                                                                                  
How did you first learn about DGH?
    • Friend/Colleague
    • Presentation/Conference
    • Another Organization                                                                                                          
    • DGH Website
    • Website                                                                                                                              
    • Other                                                                                                                                  
Why would you like to volunteer for DGH?                                                                                        
                                                                                                                                                                
                                                                                                                                                                
                                                                                                                                                                
                                                                                                                                                                
                                                                                                                                                                

What skills or talents would you like to share with DGH?

    • Web skills
    • Fundraising
    • Proposal Writing
    • Database
    • Translation
    • Public Speaking
    • Organizing/Activism
    • Graphic design
    • Research/ Evaluation
    • Other                                                                                                                                  
Previous Volunteer History: (Which organizations? Years of involvement?)                                                                                                                                                                 
                                                                                                                                                                
                                                                                                                                                                
                                                                                                                                                                
                                                                                                                                                                
                                                                                                                                                                

Would you like to receive occasional emails about future US-based volunteer opportunities with DGH?

    • Yes
    • No
I would like to be a member and volunteer of DGH. I have read and agree with the Mission Statement and Principles of Action of Doctors for Global Health (DGH) and agree to support the work of DGH with my time and/or donations. I agree not to hold DGH liable for any losses, claims or actions of any kind arising out of my association with DGH.
                                             
Date
                                                                                                         
Signature

Send your completed application to:
Doctors for Global Health
P. O. Box 1761, Decatur
Georgia 30031, U.S.A.

Please direct any questions to volunteer at dghonline.org.

Thank you!



Last Modified:
This site and its contents are Copyright © 1998-2006 by Doctors for Global Health.
Legal Notice