Volunteer Application

The completion of the form below will enable World Medical Mission to consider you for short-term ministry in a Christian mission setting. All information will be confidential and will only be shared with appropriate personnel.

ATTENTION NURSES: Limited placement opportunities for nurses are currently available.

Please wait at least 24 hours to make any changes to your submitted application.

Personal Information

Spouse's Information
Are you physically fit and free of medical conditions or disabilities, including chronic anxiety & depression that could limit your activities and/or prevent you (and others) from performing the volunteer services for which you are applying?


Medical School
Other Education


In order to properly process your application, please provide the complete addresses of references who will be contacted for professional recommendations. For residents or fellows, one of these should be your department chairperson or advisor.
1. Professional reference
2. Professional Reference

Christian Testimony and Character Reference

Missions Interest, Skills, and Experience

Travel and Passport Information
Language(s) Skills
Samaritan's Purse is an international relief organization that cares for the victims of war, poverty, natural disasters, disease and famine around the world. As such, our Disaster Assistance Response Team staff and volunteers necessarily and frequently work in harsh, hostile and dangerous settings. These environments present many challenges, such as wide-spread violence, little or no available health care, and exposure to various health and safety risks, severe weather conditions, limited housing alternatives, and obstacles to travel. Taking into consideration any long-term or ongoing health issues and limitations of available heath care, would you be able to serve a Disaster Assistance Response Team?

Disaster Response Experience and Skills

What is your level of comfort with the following?
DART Travel