Volunteer Application

CMHP Volunteer Application

Thank you for your interest in Centro Medico Humberto Parra (CMHP)! To apply for a volunteer position with our clinic in Bolivia, please complete the following application.

Name *

Email *

Title *

Other Title

*If you are an undergraduate student or M1 student, please provide a paragraph describing the project or study you hope to conduct/focus on at CMHP, as you will not be able to volunteer in a clinical capacity yet. (You will still be welcome to shadow clinicians). Past students have done research studies on birth-spacing, nutrition, and Chagas as well as public health campaigns around sexual health, deparasitation, and first aid training.

Clinical Interest(s): *

Affiliation with Institution:

Clinical Specialty(s):

Other Institution Affiliations:

Level of Spanish-Speaking Ability *

Clinical Professional References (supervisors, colleagues, professors, etc.)

Name: *

Title *

Email *

Relationship *

Name *

Title *

Email *

Relationship *

Name *

Title *

Email *

Relationship *

Travel Requests

1. Preferred date of trip (approximate): *

2. Preferred date of trip (approximate): *

3. Preferred date of trip (approximate): *

Are you hoping to travel with a friend, family member, colleague, etc.? If so, please list and explain here: *

Additional Information

Did a former coordinator or volunteer tell you about CMHP or the Daniels Hamant Foundation? Please let us know who your connection is:

Please upload your resume/CV here (pdf, doc, docx): *

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If you have any additional information to share or any questions for us, please outline here:

Thank you for taking the time to apply for a volunteer position at Centro Medico Humberto Parra. The North American Coordinator, Sarah Goldberg, will get in touch with you once your references have been contacted. If you have any questions or feel it’s taking longer than expected to get a response, please contact her at na.coordinator@hamantfoundation.org. Thank you!

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