Medical Personnel Volunteer Application Form

 

Please only apply for this role if you meet all the requirements below:

* Required

 

Education and Training

In order of most recent


Qualification Two

 

Professional References

 

 

Experience of Delivering Medical Aid Overseas

 

 

Documents

 


*
I confirm that the above information is correct. I understand that any false information or deliberate omissions will disqualify me from volunteering. I consent to Physicians Across Continents using and keeping information I have provided on this application and elsewhere as part of their volunteering process and/or personal information supplied by third parties such as referees, relating to my application for future volunteering roles. I understand that the information provided will be used to make a decision regarding my suitability for volunteering and if successful the information will be used to form my personal record and will be retained for the duration of my volunteering. If I am not successful, I understand that Physicians Across Continents will retain the form for as long as is deemed necessary and that Physicians Across Continents may use it to contact me in the event of there being any other volunteering opportunities for which I may be suitable.

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