Project Helping Hands

Team Application Directions

Please fill out the application below to be considered for an upcoming team. Make sure you identify which team you are interested in traveling with. You may only apply for one team per submission. Fields in blue are optional, all other fields are manditory and must be completed before you application will be accepted.

Note that passports must be obtained prior to departure. Once you have obtained a passport, please email it to our travel coordinator, Elizabeth Degerstedt at elizabeth@project-helping-hands.org

Team Applicaton Deadlines:

JUNGLES OF BOLIVIA - DUE September 30, 2010
HAITI - FEBRUARY - DUE September 15, 2010
HAITI - JULY - DUE December 31, 2010
LIBERIA - APRIL - DUE September 16. 2010
KENYA - MAY - DUE November 15, 2010
PHILIPPINES - DUE November 15,2010
BOLIVIA - PANDO RIVER - DUE February 15, 2011
KENYA - OCTOBER - DUE March 30, 2011
BOLIVIA - MULE PACK - DUE May 15, 2011

It is important to read the team descriptions so that you understand the type of team and kinds of experiences you are signing up for as some team are extreme teams, meaning very rough conditions.

Team members are selected based on their skill match to the team applied for.

Team Applying For:

Personal Information
First Name: (Must match passport)	Preferred Name:
Middle Name: (Must match passport)
Last Name: (Must match passport)	Gender:	Male Female

Primary phone:	Alternate Phone:

E-Mail Address:	Alternate E-Mail Address::

Mailing Address (versus street address):
City:
State/Province:
Zip Code:

Date of Birth:
Place of Birth:

Shirt Size:

Preferred Airport you will depart from:
Alternate Airport:

Passport Information
Are you a United States Citizen?
If No, please list the country you maintain citizenship

Passport #		Passport Country:
Passport Point Of Issue

Passport Issue Date:	(if no passport, please put in today's date)
Passport Expiration Date:	(if no passport, please put in today's date)

Emergency Contact Information
Emergency Contact:		Emergency Contact Email:
Emergency Contact Relationship:		Emergency Contact Phone:
Emergency Contact Mailing Address:
Emergency Contact City:
Emergency Contact State/Province:
Emergency Contact Zip:

Professional Information
Reason For Applying:
Medical Training:
Profession:
Professional Background:
Language Skills:
Prior Teams: (please type NONE if not applicable)
Referred By:

Please make sure that you have checked over all of your information in the above form and that it matches the information on your passport. Airline tickets will be based off of this information and any errors submitted may result in additional costs at the applicants expense. Check this box to verify that your information is valid and that you are aware of the consequences that may ensue if information is incorrect.



Please note: There is a $10 Application Fee (non-refundable) due when you submit this application. This fee does not count towards team fees. Once you submit this application, you will be able to click on a link to pay for this fee. Be sure to click "Special Instructions" as you complete the PayPal form to indicate which team the donation is for as well as the applicant name.