Active General Member Application 2022-2023
UCSD Flying Samaritans is a student-run non profit organization. We provide free medical, dental, and public health services to low-income communities in Ensenada, Mexico through our monthly day trips.

Please complete the following form to apply for a 2022-2023 Flying Samaritans Active Membership.

Active Members: Register, pay annual membership fee, accumulate points
 
Committee members: Register, pay annual membership fee, requires separate application

Trip Selections:
Sign-ups open 2-3wks before trip date
Based on number of points
Drivers, Spanish Speakers, Committee Members get priority

As an active member, each quarter you will be required to:

1. Attend two GBMs or bring a friend to one GBM. Our GBMs are held on three Monday nights throughout the quarter at 7pm.
2. Attend a total of four other events as follows:
Attend 1 Social event per quarter
Attend 1 Fundraising event per quarter
Attend 2 volunteer events (clinic, community outreach, medical/public health events) per quarter

If selected, you will be given priority selection on at least one clinic trip per quarter.
If selected, active members are required to pay a $40 yearly membership fee at time of acceptance. (Disregard if you have already paid this fee)
Email *
First Name *
Last Name *
Email *
Do you have a car and would you be willing to drive volunteers to and from clinic? (You will be marking specifically if you can drive on the actual clinic trip sign-ups; you do not need to worry if you cannot drive for every trip, we just want to know if you are interested in driving) *
If you answered "yes" to the above question - Including yourself, how many passengers does your vehicle hold?
How would you rate your fluency in Spanish? *
What form of identification will you be using to attend clinics? *
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