New Orleans Medical Mission Services Foundation, Inc.

Volunteer Form

 

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Thank you for offering to volunteer. Please tell us how you can help by filling out the form below. You will be taken to a web page that recaps your entry. You will not receive an immediate email response, but be assured that we will contact you within a couple of weeks. If you need immediate feedback, contact us by telephone.

 

Mr., Mrs., Ms., Dr., etc.

First Name

Last Name:

Jr., III, Sr., PhD, MS, JD, Esq., etc.
Spouse:

Spouse's Name
email address:

example@isp.com
Home Street
Address 1:
Home Street
Address 2:
Home City:
Home State, Postal, Country

State or Province

Postal or Zip Code

Country
Work Street
Address 1:
Work Street
Address 2:
Work City:
Work State, Postal, Country

State or Province

Postal or Zip Code

Country
Phone numbers:

Daytime

Mobile

Fax
Check all that apply:

Medical Mission Team

Certification:
Specialty:

Mission:

Preference of Mission Assignment

Fund Raising Team

 

Gala Activities:

   Other Fundraising:
Invitation Event Speaker
Food Donations Event Booth
Beverage Donations Mailings
Auction Donations Public Relations
Decorations    
Auction Processing and Checkout    
Other    

Administration Support Team - Admin and Computer Support

Material Preparation Team - Sort, Pack, and Inventory Medical Supplies

Material Solicitation Team - Material, Instruments, Supplies

Technology - Internet Support

Technology - Warehouse Automation

Technology - Mission Field Support
Comments

Describe your skills, availability, any limitations, and any other comments. For Example, “can solicit hospitals and /or supply companies”… “have contacts for food, beverages, gift items”…“have computer, recordkeeping, publication skills”

W  P

 

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