2024 AMOS Mission Experience - Volunteer Application Form
Thank you for your interest in serving with AMOS Health & Hope! This application form is the initial step of the application process to becoming a member of this mission team. Please fill out the whole form to the best of your ability. The information will be submitted to the AMOS Delegations Team and you will be contacted upon review. Thank you for taking the time to apply with AMOS!
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General Information
First Name *
Middle Initial *
Last Name *
Date of Birth - DD/MM/YYYY *
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Street Address *
City *
State *
Zip Code *
Country *
Primary Phone Number *
Preferred Email Address *
AMOS Staff may contact you to schedule a brief call as a part of the selection process.
Sex *
Citizen of the United States *
If not a US citizen, what is your country of citizenship?
Valid Passport *
Passport Number *
Have you ever been convicted of a criminal offense? *
If yes, please explain
Program Information
I understand that the cost of this 10-day program is $152 per day, for a total of $1,520 per person. *Airfare is not included and you must cover this on your own. *
 I understand that my participation in the program will not be official until I deposit a $150 non-refundable fee that will be applied towards your total trip costs. * *
How did you hear about this volunteer opportunity? *
Required
Relevant Education and Experience
Highest Level of Education Achieved
Clear selection
Please share the name of the school where you completed your highest level of education and title of your degree (if relevant). *
Please state any skills or experiences you have had that you feel are relevant to the AMOS Mission Experience. *
Level of Spanish Fluency *
Please explain why you chose to rate your Spanish language skills at this level. *
Have you previously traveled outside of your home-country? If yes, please share where. *
General Medical Information
General Health for the past 2 years? *
If you have any specific health conditions, please explain.
Allergies *
If necessary, please explain.
Current Prescriptions/Medications/Special Health Information
Do you agree to the statement below? *
If a medical emergency should arise for me during my visit to Nicaragua, I hereby give permission to a qualified medical physician and/or hospital to provide the appropriate care and to administer any emergency medical treatment, which may be required for me. I also hereby give such medical personnel and/or hospital my permission to any necessary examination, anesthesia, medical diagnosis, or treatment and/or hospital care to me. I understand AMOS Health and Hope and any representatives or missionaries cannot assume responsibility for medical expenses for me and I agree to bear such responsibility and pay any such expenses incurred with respect to such medical emergency.
Volunteer Motivations and Expectations
Please share what motivates you to participate in the AMOS Mission Experience. *
Please state what expectations you have for this opportunity to serve with AMOS. *
Give a brief description of what you think it means to serve. *
I confirm that I am, indeed, the person applying for this position and that the submitted information is true. *
Initials *
Date *
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