COVID-19 Information

Apply!

Deadline: 11:59 pm on Wednesday, November 2nd, 2022

Program only offered to first year Geisel Medical students and TDI students

Entries marked with * are required.

Personal Information

Legal Name*:

(as it appears on your ID)

Date of Birth*:

Gender:



Affiliation*:



Address*:

Email*:

Cell phone*:

What roles are you willing to be responsible for?

Pre-Trip:








During the Trip:





Post-Trip:




Please answer the following questions

Please describe your leadership or community service experiences and what you learned from them*:

What have been your experiences with diverse cultures and languages?*:

How can you contribute to this trip, would you be willing to help out with the planning process?*:

Are you a certified Dartmouth College driver?*:



If not would you be willing to become certified?:



If you have any questions please contact Shawn O'Leary.