Volunteer application

Step 1 of 6 Your placement

Tell us how you would like to serve and when.

I would like to volunteer as

Medical volunteerSurgeons, physicians, anaesthetists Allied health volunteerPhysiotherapy, radiology, laboratory and more Nurse volunteerTheatre, ward and ICU nursing OtherAdministration, IT, teaching and more

Period you are applying for

February – JulyFirst half of the year August – NovemberSecond half of the year

Year

How long can you stay?

Step 2 of 6 About you

We use these details to contact you about your application.

First name

Middle name (optional)

Last name

Email address

Mobile phone With the country code, e.g. +1 555 123 4567

Home phone (optional)

Work phone (optional)

Street address

City

Postal or ZIP code (optional)

Country

Step 3 of 6 Emergency contact

Someone we can contact if anything happens while you are with us.

Full name

Relationship to you (optional)

Telephone

Email address (optional)

Address

Step 5 of 6 Medical form

Download the medical health information form, fill it in, then scan or photograph it and upload it here.

Download the medical health information form (PDF, 2 pages)

Completed medical health information form

PDF, JPG or PNG, up to 5 MB. Several pages? Choose up to 4 files.

Your CV (optional)

PDF or Word, up to 5 MB.

I certify that the information in this application is accurate to the best of my knowledge.

Step 6 of 6

Check and send

Look over your answers. Use “Change” to correct anything, then send your application.