DGH Voting Member Application

Doctors For Global Health (DGH) is an organization that relies on the integrity and volunteer spirit of its members. We want to thank you for all the time and effort you have put into furthering our work. We seek people to serve as Voting Members who are serious about promoting health and education as basic human rights and who have demonstrated knowledge of and a commitment to the mission of DGH. The following questions will help us better consider your interest in DGH and your application for Voting Membership.

DGH Principles of Action

DGH Mission

Sign in to Google to save your progress. Learn more
Email *
Name *
Today's Date: *
MM
/
DD
/
YYYY
Phone number *
Address (include state, country, and zip code) *
What first attracted you to DGH?
 *
DGH’s goal is to “Promote Health and Human Rights With Those Who Have No Voice.” What does that mean to you?
 *
Why are you interested in becoming a Voting Member of DGH?
 *
To become a Voting Member of DGH, you must have been an active volunteer for at least one year.

Please list the activities you have engaged in as a DGH volunteer and note the approximate amount of time you devoted to each.
 *
Which of the following activities would you like to participate in as a Voting Member of DGH (check as many as you like)? *
Required

List any languages you speak (other than English) and check your proficiency in them.

Selecting "Yes" below will serve as your electronic signature for the following:

I acknowledge that becoming a Voting Member of Doctors For Global Health (DGH) carries with it certain responsibilities and commitment. As a Voting Member I would have the power to influence the direction DGH takes in the future. I agree to uphold the Mission and Principles of Action of DGH. I also agree not to hold DGH liable for any losses, claims or actions of any kind arising out of my association with DGH.

 *

By electronically signing this document above, you authorize any details concerning information requested herein to be made available to the Board of Directors of DGH. This information will be held in strict confidence and will be used only for the purpose of this Voting Membership application and to help match your experience with volunteer opportunities at DGH. Any false, incomplete, or misleading statements, or omissions by you in this application or in any other credentials submitted by you to DGH will be cause for rejection of your application or for your immediate dismissal if you become a Voting Member. 



Thank you for taking the time to complete this application and for your interest in DGH. Your application will be reviewed at the next meeting of the DGH Board of Directors.

Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Doctors for Global Health. Report Abuse
Google Forms