Volunteer Application

Please note: volunteers who are not medical professionals serve Bethany’s Angels in many valuable support roles. However it is necessary to fill all expedition openings first with trained medical professionals. Therefore, all students or non-medical trained applicants for field operations are required to recruit an MD, PA or equivalent to accompany them. Details on specific mission needs and specialties can be obtained by contacting the foundation’s director at Randy.Salo@BethanysAngels.com.
This requirement does not eliminate non-medical applicants who are unable to recruit from applying. Please do so as we wish not to turn anyone away. Our primary objective is to fill the ship’s muster list with medical professionals first.

Request for Information
  1. (required)
  2. (valid email required)
Professional Background
  1. Have your professional privileges ever been suspended/revoked?

Passport Info
Emergency Contact
Applicant Survey
  1. Do you consider yourself physically fit enough to assist with light shipboard duties?

  2. Do you have any physical disabilities that may limit your involvement?

  3. Have you any boating experience?

  4. Are you susceptible to seasickness?

  5. Are you comfortable with being at sea for up to 6 days?

  6. Are you able to work in a team, under a superior’s supervision?

  7. Are you comfortable with living in close quarters with unfamiliar people?

Additional Information
  1. Have you immunizations for foreign travel as prescribed by the CDC?

  2. Do you have any special dietary needs?

  3. Do you have any medical conditions we need to be aware of?

  4. Have you ever participated in overseas healthcare work?

Release and Indemnification
  1. By submitting this form I hereby release and indemnify Bethany’s Angels Foundation Inc., which is a non-profit corporation, and all it’s respective officers, directors, agents, contactors, employees, heirs, successors and assigns from prosecution or presentation of any claim for bodily injury or death or for property loss or damage incurred in connection with Bethany’s Angels Foundation, Inc., expeditions or related activities.
  2. Please email or post mail, photocopies or scans of current licenses or certificates (if applicable), and a passport size photograph to: the addresses shown below this form
 

cforms contact form by delicious:days

Randy.Salo@BethanysAngels.com

Or:

Bethany’s Angels Foundation, Inc.
13210 N. 72nd Place
Scottsdale, AZ 85260

Thank you for your interest and good luck!