Team Application

Submitted by Anonymous on Fri, 2011-02-11 11:58

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 marked with an asterix are mandatory 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 your passport information to our travel coordinator, Elizabeth Degerstedt at elizabeth@project-helping-hands.org

Personal Information
(Must match passport)
(Must match passport)
(Must match passport)
(address where you can receive mail and packages)
Professional Information
For medical and licensed professionals only
To be considered for medical or dental placement
To be considered for medical or dental placement
Passport Information
Emergency Contact Information
Please type NONE if not applicable.
Because we send teams to remote areas of the world where there are potential health hazards and risks, varying levels of physical demands, limited hygiene facilities, extreme weather and very basic living conditions, it is critical that all members on any team are in appropriate physical and mental condition to handle the level of challenge present in the trip applied for. Each trip and location is different and will pose different types and levels of challenges, which Project Helping Hands outlines on the website in the trip descriptions. It behooves everyone on the team as well as the people we serve to make sure all members of a team are in appropriate condition to handle the rigors and stresses that will be faced on each mission. Having medical or mental conditions does not necessarily disqualify you from joining a team. It is helpful for team leaders to be aware of potential medical issues team members may have. (Examples of the types of conditions we want to be aware of include: diabetes, heart disease, hepatitis, asthma, sleep apnea, seizure disorders, and problems that limit mobility.) Do you have any physical limitations or medical conditions that could prevent you from safely participating in the trip you are applying for?
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 applicant's 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 $300 Deposit Fee due when you submit this application. If selected as a team member this fee will be applied toward the cost of your trip and is non-refundable per IRS regulations. In the event that you are not selected for this team you have the option of either a refund of the full Application Fee, you can apply these funds toward another PHH trip or you can donate these funds to PHH and receive a tax deduction receipt for your donation. Once you submit this application, you will be directed to our donation page to pay for this fee. (Our preferred method of payment is by "E-Check" rather than credit card. In 2012 we paid out $18,000 in credit card fees and would prefer to put the money to use supporting our programs rather than the credit card companies!) We are not charged a processing fee for E-Checks!
Be sure to select the trip you are applying for from the pull-down menu under "Please direct my donation to:".