This fee includes all costs associated with the Medical Mission such as food and transportation within the mission site. It does not include any personal costs you may encounter during your free time.
Associate member includes one who wants to volunteer their time (before, during or after the mission at any capacity), is NOT a US Citizen, and does not have voting rights.
An active member is one who wants to volunteer their time (before, during or after the mission at any capacity), is a US Citizen, and has voting rights.
IF YOU ARE LICENSED IN THE PHILIPPINES OR ARE NOT A DOCTOR, DENTIST, OR A NURSE, PLEASE DISREGARD THE FOLLOWING INFORMATION.
The processing time to secure Temporary Permits is 3 months. Therefore, all certified licenses to the Philippines are required to be submitted by October 22. We can not process last minute temporary permits.
For those who are licensed in DC and VA, please scan and email it to Jhettepp@aol.com or fax a copy to (703) 373-8952. (pictures of the license will not be accepted).
The deadline is October 14, 2018.
For those who are licensed in MD, please email your license number to email@example.com and it will be processed appropriately. The deadline is for Maryland licensed providers is October 14th, 2018.
For those outside of MD, VA or DC, please email firstname.lastname@example.org, and state your name, credentials, and state of residence to guide you in the process of obtaining your state's license. This includes the seal from the Philippine Embassy or Consul. The certified license with the seal from the Philippine Embassy must be received by me no later than October 20, 2018.
All licenses must be certified by the Secretary of State (each state has a different process) and then certified by the Philippine Embassy (depending on which state you are in, your license must be certified by the Philippine Consul which has jurisdiction over your state) before we send the licenses to the Philippine Regulation Commission (PRC).
Notes: 1. Your acceptance will be based on the information provided on this form. 2.You will be responsible for arranging your own funding for the costs of the trip to include travel expenses, lodging (prior to and after the mission dates) , Evacuation Insurance ( optional ) . 3. The major costs of the trip will be managed by MMOM USA which will include lodging (during the Mission trip and only if you stay for the full duration of the mission trip) , Food during the Mission only, Transportation/Transfers to and from the mission site and Miscellaneous costs such as purified water, hand gel, paper products, etc. The costs of your voluntary participation may be tax deductible. The Medical Mission of Mercy USA is a non-profit 501 (c) 3 organization in the State of Maryland. You should consult your tax advisor on this matter. 4. Travel arrangements: You are responsible for coordinating your flight itinerary. Each volunteer will be informed in advance of the pre-determined meeting place. Upon arrival at the predetermined location, MMOM, USA will make all necessary arrangements to and from the mission site. If you are not able to meet the group at the pre-determined location and / or cannot stay for the full duration of the mission, you will be responsible for your own arrangement to and from the mission site. We encourage you to discuss all alternative arrangements with MMOM, USA. Deadlines are established and must be adhered to at all times to include but not limited to paperwork and payments. I hereby apply for membership in the Medical Mission of Mercy, USA (PAMMMWDC, Inc). If accepted as a member, I promise to abide by the Constitution and By-laws of the Medical Mission of Mercy, USA.
Accepted file types: pdf, Max. file size: 5 MB, Max. files: 3.
Drop files here or