FOCOS VOLUNTEER APPLICATION FORM

Name *
Name
Address
Address
Date of Birth
Date of Birth
Emergency Contact *
Emergency Contact
Age Bracket
In what medical capacity do you wish to serve with FOCOS?
Please select multiple if applicable
In what non-medical capacity do you wish to serve with FOCOS?
Please select multiple if applicable
Have you applied to FOCOS as a volunteer before? *
Are you able to raise funds to serve with FOCOS? *
Funds are used to support your travel, accommodations, and meals while in Ghana.
Have you ever been convicted of a criminal offense? *
Are there any circumstances (medical or other) which could interfere with your meeting the requirements of the volunteer position? *