Interest form
Welcome to the UIC Chapter of VAW Global Health Alliances! 
We are a medical outreach program aiming to create sustainable and equitable access to health care around the world.
Our goal is to recruit and send interns on a medical mission trip to countries including: Cambodia, Dominican Republic, Guatemala, Panama, Peru, and Vietnam during the 2022-2023 school year! This year we are going to Guatemala during Spring break. This is an amazing experience that can be valuable to future physicians, physician associates, nurses, etc.
Sign in to Google to save your progress. Learn more
Email *
First name
Last name
UIC email
School year
Clear selection
Do you plan on coming to the Medical Mission Trip?
Clear selection
How do you plan to fund for the program fee (US $1040 + Meds Fund $100)? What ideas of personal fundraising will you apply?
How many hours per week can you contribute to VAW Health Alliances? (for fundraising, group meetings, etc.)
What are you most excited about being a member for VAW?
Please feel free to leave any questions, comments, or concerns!
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms