PROJECT SELECTION (page 1 of 5)

Are you travelling with a family member, friend, or as part of a group?

PARTICIPANT INFORMATION (page 2 of 5)

PASSPORT

The majority of countries we serve in REQUIRE your passport to be valid for at least 6 months beyond the date that you leave the country. If your passport will expire before then, we recommend that you begin the renewal process immediately.

The name information below must be exactly as it appears on your passport

MAILING ADDRESS (HOME)

OFFICE MAILING ADDRESS

FAITH 

MISSION EXPERIENCE

EMERGENCY CONTACT INFORMATION

PROJECT ROLE: How will you serve on this project? (page 3 of 5)

PROJECT ROLE

After submission of this application, you will receive an email asking you to provide documents.

Medical Professionals, we also need your:

• Current License (through time of project)

• Diploma

• Curriculum Vitae or Resume

HEALTH INFORMATION (page 4 of 5)

MEDICATIONS

MOBILITY LIMITATIONS

ALLERGIES

DIETARY RESTRICTIONS

EMERGENCY INSURANCE BENEFICIARY

MMI provides emergency evacuation and limited medical insurance during the project.  Whom would you like to list as your beneficiary?

HEALTH COMMITMENT

I affirm that I am physically able to participate in the required activities of an MMI Project. Should my health deteriorate prior to the project, I will obtain medical clearance from my health care provider to ensure the safety and well being of my team members and our patients.

AGREEMENTS and CONSENT (page 5 of 5)

PROJECT ACCEPTANCE

I understand that acceptance of my application on this project is contingent upon further review, along with the receipt of credentials and other requested documents. 

AGREE TO SHARE INFORMATION

I am willing to share my contact information with other members of my MMI project team. (If not, MMI may still need to share your contact information with limited individuals for pre-project planning, including delivery of supplies.)

APPLICATION DONATION

I understand that a non-refundable donation of $100 USD for Americans or $140 CDN for Canadians & Internationals must accompany my application.

PROJECT DONATION

I understand the donations for project participation are required 45 days before departure.

AIRFARE DONATION

I understand that donations to cover airfare are in addition to the project donation.

Canadians  - The donation for airfare is required within 30 days of booking.

Once you are accepted on the project, you will receive notification from the MMI Project Coordinator,  who will provide our designated travel agent information so you can arrange your travel and cancellation insurance.

MMI's approved travel agent is used in order to provide you with services to coordinate travel itineraries for the project team. If you desire, the travel agency will work with you for additional vacation plans after your project.  
 

PREAUTHORIZE

I agree to pre-authorize my credit card for the balance of my project donation and airfare if applicable.

CANCELLATION POLICY

All funds received by Medical Ministry International are charitable donations which may be directed to the fundraising efforts of a specific Project Team or Program. Although Medical Ministry International will track the fundraising efforts of individuals, all donations are made to support a Project Team.

In the event of cancellation by a participant or by Medical Ministry International, donations may be re-directed to support a future project team within one year, a country-specific need, or the greatest need of the organization.

CONDUCT STATEMENT

To ensure respect for MMI's international partners, participants will conduct themselves in a manner consistent with promoting a Christian witness in the communities we serve

• Project Directors will communicate local expectations for participants which may include dressing modestly and refraining from alcohol.
• Only married, heterosexual couples may stay together when such accommodations are available.

SEXUAL MISCONDUCT POLICY: PROJECT TEAMS

It is the policy of Medical Ministry International to treat all MMI agents, project directors and participants of with respect and dignity. Click here to view the full policy on our website.

VACCINATION POLICY (Approved Jan 18, 2023): Click here to view the full policy on our website. 

INFECTION, PREVENTION, and CONTROL POLICIES & PROCEDURES: (Approved Jan 18, 2023): Click here to view the full document on our website.

Participation Agreement & Waiver of Responsibility (Approved July 8, 2024)

1. I, the participant (parent or guardian), understand that Medical Ministry International may make the decision to cancel a project team with minimal notice if the health, safety, or security of the team is of specific concern due to outbreaks of disease, political unrest, or natural disaster. If a project team is cancelled, I agree to follow the published MMI Cancellation Policy.
2. I, the participant (parent or guardian), understand that every project team will face certain risks and hazards while travelling internationally, including but not limited to injury, disease, kidnapping, and theft. I am fully aware of all the risks and hazards inherent in participation in the activities of project team travel and the provision of health care services while volunteering with Medical Ministry International.
3. I, the participant (parent or guardian), freely and voluntarily agree to assume all the risks, including the risk of death, bodily injury, disease, infection, or property damage, regardless of severity, that I may sustain as a result of my participation in the activities of Medical Ministry International, howsoever arising, including, but not limited to, the active or passive negligence of the Releasees.
4. I, the participant (parent or guardian), along with the members of my family, in consideration of the benefits derived if accepted for a project, hereby voluntarily waive any claim for any reason against Medical Ministry International, Medical Ministry International US, their officers, directors, corporation members, staff, agents, and sponsoring institutions.
5. I, the participant (parent or guardian), agree to abide by the current regulations and restrictions as outlined by the governments of all countries I travel to/from and the Public Health guidelines of all those countries.
6. I, the participant (parent or guardian), understand that any unused project funds will be used to continue the ministry in the country after the project team leaves.
7. I, the participant (parent or guardian), have read, understood, and agree to the participation agreement and waiver of responsibility.

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