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APPLICATION DETAILS
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Medical Volunteers
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Periods of Application
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Duration for volunteering in Weeks or Months.
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CONTACT DETAILS
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*
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EMERGENCY CONTACT
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PLEASE ANSWER THE FOLLOWING
Have you applied to FOCOS before?
Yes
No
Do you have friends or relatives who have served with FOCOS?
Yes
No
Kinldy state their name
Are you able to raise funds to serve with FOCOS?
i.e return flights to Ghana, cost for vaccinations, $350 flat rate for food and accommodation.
Yes
No
Have you been convicted of any criminal offense?
*
Yes
No
Please explain
Have you been named in medical malpratice suit?
*
Yes
No
Please explain
Are there any circumstances (Medical or other)
Are there any circumstances (Medical or other) which could interfere with you meeting requirements of the position you're applying for?
Yes
No
Please explain
Please explain why you wish to serve with FOCOS
*
MEDICAL HEALTH INFORMATION (Please follow instruction)
Click here to download Medical Health Information Form
Once completed, scan and upload via the browse button.
Why medical health information
*
The primary purpose of obtaining this information is to determine medical eligibility for service abroad. The information on this form may be made available to appropriate staff. Failure to provide accurate information may result in changes to volunteer role.
Maximum size 4MB
I certify that the foregoing information is accurate to the best of my knowledge.
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