Volunteer Interest Form

We’re excited that you are interested in volunteering with us! Please fill in this brief interest form to let us know a little bit about yourself. You can also email us to volunteer@cmmb.org if you have any questions.

First Name*

Last Name*

Email*

Region of Residence*

Select

Which of the following volunteer opportunities are you interested in?*

Please choose the most suitable option based only your availability and professional profile

Internship with New York team (150 hours within 1-3 months, in New York or remotely)

Project-based service for skilled professionals (New York-based or remotely for a min. of 25 hours)

Mission trips overseas (7-15 days at rural hospital in Haiti, Kenya or Zambia)

Clinical rotations at rural hospital overseas (1-2 months in Haiti, Kenya or Zambia)

Long term service overseas (3-12 months in Haiti, Peru, Kenya, South Sudan or Zambia)

Mentorship and Education (remotely or in person in Haiti, Peru, Kenya, South Sudan or Zambia)

Retiree Professionals (2 days per week New York-based or remotely for 4+ months)

Highest/Most Relevant Degree

Select or enter value

If other advanced degree, specify here:

Your Professional Profile*

If you are a student, please select the profession you are studying for

Select

University Name

Earliest Start

Where would you like to volunteer?

New York

Haiti

Kenya

Peru

South Sudan

Zambia

I would like to volunteer from home

Please attach your resume here labeled with your full name.

Drag and drop files here or

Questions? Comments?

Acknowledgement

I acknowledge that the information provided here is true and I understand that if accepted for a role as a volunteer, CMMB will require letters of reference, conduct a background check and license check (if applicable).

Send me a copy of my responses

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