International Volunteer Application

Hospitals of Hope - Volunteer/Mission Opportunities

Departure Date: Month: Day: Year: Trip Cost Calculator

Return Date: Month: Day: Year:

• Please send a photo of yourself (may email to This e-mail address is being protected from spambots. You need JavaScript enabled to view it )
• $125 deposit (This is transferable but not refundable.) Put down your deposit online.

Name as it appears on your passport (if available)

First: Middle: Last:

Preferred Name:
First: Middle: Last:
female

Current Mailing Address:

Street: City: State:

Zip Code: Country:

Home Phone: Alternate Phone :

Email:

Permanent Mailing Address (if applicable)

Street: City: State:

Zip Code: Country:

Citizenship:

Birthday: Month: Day: Year:

Passport Number (if available):

Place Issued: Date Issued:

Place of Employment:

Employer's Address:

Street: City: State:

Zip Code: Country:

Job Title:

College/University You Currently Attend:

Undergrad: Grad School/Seminary:

PhD:

Major: Minor:
Anticipated Graduation Date: Month: Year:

Church You Currently Attend:

Pastor’s Name:

Church Address:

Street: City: State:

Zip Code: Country:

In Case of Emergency, I would like Hospitals of Hope to notify:

Name: Relationship:

Address:

Street: City: State:

Zip Code: Country:

Daytime Phone Number:

Evening Phone:

Email:

Health Status
Do you have any medical restrictions or handicaps that we need to make provision for?
no

(if yes please explain)
Are you presently taking any medications?
no
(if yes please explain)
Do you have any dietary restrictions that we should plan for?
no
(if yes please explain)
Health Insurance Company: Policy #
Physician’s Name: Phone #

Primary Area in Which You’d Like to Serve (select one):
Medical Dental
Casa De Amor
(orphan ministry)		 Spanish Translation

Other Areas in Which You’d Like to Serve (select all that apply):
Medical Dental
Casa De Amor
(orphan ministry)		 Spanish Translation

Medical/Dental applicants only: I am currently (select all that apply):
Doctor Specialty:
Nurse Dentist
MedTech Student
Other: Specialty:

Also please email the following items to This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Undergrad

Grad students

  • Same as above +year in school/level of training or study

Medical Professionals

Do you speak Spanish?
no
Please rank your level of Spanish proficiency, with 1 being no Spanish and 5 being fluent.
2 3 4 5
Are you proficient enough to be an interpreter?
no
Will you need a Spanish translator?
no
Travel Information
Closest major airport: 1st choice:
2nd choice:
Are the dates selected flexible?
no
If yes explain:
Please answer the following:
Short-answer questions (please answer in 1-4 sentences)
1. What is your primary reason for wanting to serve overseas?
2. Have you served on any overseas missions projects before? If so, please list mission organization, date, & purpose.
3. In what ways do you believe you’ll be able to impact people overseas?
4. What do you hope to learn or gain from this experience?
5. Are there any realistic roadblocks that might hinder you from going?
6. What does the word “flexibility” mean to you?
Long-answer questions (please answer in approximately ½ a page)
1. Describe your relationship with Jesus Christ and how you became a Christian.
2. What do you see as some of your strengths and weaknesses?


Please provide a list of references including name, address, phone #, and email address.
  • One Christian leader from your church (can be Pastor, Sunday School Teacher, Bible Study Leader, etc)

  • Two others who know you well. Cannot be a family member. We would suggest a teacher, boss, coworker, fellow-student, or friend.

*Please note that we are not looking for perfect volunteers. Please don’t let this application be a hindrance to you in any way!
Hospitals of Hope is a 501(c)3 non-profit organization. To obtain our receipt for tax purposes, make all checks payable to Hospitals of Hope and please write a specific information on a separate sheet of paper, NOT on the face of the check. All funds raised above and beyond your targeted goal cannot be refunded but will be used to further the ministry of Hospitals of Hope
WAIVER OF RESPONSIBILITY

I, along with all members of my family, in consideration of the benefits derived if accepted for a Hospitals of Hope Project, hereby voluntarily waive any claims for any reason against Hospitals of Hope International, the officers, board, leaders, staff members and sponsoring institutions.

I, will submit to the godly leadership of HOH staff.

I, will have the full cost of my trip in to Hospitals of Hope by the date departure.

Signed Date:

*Waiver must be signed by each applicant. Parent or Guardian must also sign for minors.