CRUDEM VOLUNTEER APPLICATION FORM
(please email to volunteers@crudem.org)
Please put answer next to each line.
1-what is your specialty in medicine
2-when you can go
3-how long you are available
And this travel info:
1 – full name as it appears on passport
2 – US address
3 – date of birth
4 – US passport number
5 – passport expiration date
6 – passport place of issue (under “authority” on photo page)
7 – nationality/citizenship
8 – gender
9- weight
10 – cell phone number
11 – email address
