Volunteer Positions:
Specialty, if any:
If you have performed ECCE in your practice, please indicate the number of years practicing ECCE:
Why do you want to participate on a VHI mission?
What special skills, talents or interests will you bring to this program?
Have you participated in other overseas medical programs?
If yes, please list the countries and dates of service and briefly describe the program:
Please specify any other information you want to share with us, or if you have any specific questions:
How did you hear about VHI?
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