C.U.R.E. Clinics Participant Application

  • 1 Current: Personal Information
  • 2 International Travel Experience & Expectations
  • 3 Complete
Select Trip
TRIP FULL
Volunteer Type
Please list countries and purpose of travel.
If so, please indicate trips and dates.
Include any skills, training, certifications, or qualifications you will bring to the trip, as well as what you expect to take away from this experience.    
International trips can be both emotionally and physically challenging. Are you able to cope with such challenges?
I CERTIFY that all statements and information furnished in this Statement are true, complete and correct to the best of my knowledge and belief and are made in good faith. I understand that any information furnished on this form is subject to verification, and I agree to furnish supporting documents or information upon request and/or names, addresses and phone numbers (if known) of officials or other individuals who can substantiate the qualifications described above. I also understand that intentional misstatements or falsification will result in disqualification.
 
I understand that my participant program fees are a non-refundable donation to Project C.U.R.E. Should I need to cancel my trip, I understand that I may use funds paid as a credit for future CURE Clinics.
 
How did you learn about CURE Clinics?