DGH Guidelines for International Volunteers

Doctors for Global Health
Membership Application

Full Name:
Birth Date:
Address:
Telephone:
Fax:
Email:
Occupation:
Organizational Affiliations:
Language Abilities and Level:
DGH respects your personal privacy. DGH will never release your name, street address, telephone number or e-mail address to outside organizations without your consent. I, the undersigned, hereby certify that I agree with the Mission Statement and the Principles of Action of Doctors for Global Health (DGH) and wish to become a member. I understand that as a member I will receive the DGH Reporter and e-mail updates about DGH events and volunteer opportunities.

Signature
Date

DGH Mission Statement

To improve health and foster other human rights with those most in need by accompanying communities, while educating and inspiring others to action.

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

Please direct any questions to the DGH registrar.