VOSHTM Northeast Volunteer Optometric Services to Humanity

Mission Application

Mission Site:                Mus, Turkey

Mission Date:              August, 2005

Name:       
                 

Title/Degree:              

Address:
                     

Tel:
                             

Email:                         

Number of previous Vosh and/or Vosh Northeast missions:

Which team did you primarily participate with on your most recent mission?:

List any medical missions, other than Vosh, you have participated with and briefly describe your activities:

Indicate if you can assist in the procurement, contribution, and/or organization of medicines, supplies, and/or equipment:

Comments:

To download this application as a Microsoft Word Document, click here 

Please email this application to Ali C. Hocek, ach@hocekarchitecture.com, within one week after your receipt