2017 Volunteer Application
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This application is outdated. To view our updated application, please continue.

 
First Name *

 
Last Name *

 
Gender *


 
Your Date of Birth *

 
Mobile Phone Number *

Please include country code.
 
What is the best time for a member of our team to contact you via phone? *


 
Your time zone *


 
Name of University *

 
Field of Study *

 
Are you interested in receiving course credit for your enrollment in our program? *

     
 
Passport - Country of Issue *

 
What is your English language proficiency? *


 
How did you hear about OHS?


 
Please specify the name of the Professor/Admin that referred you. *

 
Please specify the name of the friend that referred you *

 
Please specify the name of the OHS rep that referred you *

 
Have you ever been banned/barred from a university campus or other public place/institution. *

     
 
Provide documentation or written explanation. *

 
Have you ever been convicted of a felony? *

     
 
Provide documentation or written explanation. *

 
Which program are you applying for? *


 
Preferred Location: *


 
Select your preferred programs in Jamaica (Top 3)

 
1st Choice [Jamaica] *


 
2nd Choice [Jamaica] *


 
3rd Choice [Jamaica] *


 
2nd Choice *


 
3rd Choice *


 
Select your preferred program dates in Cape Town (Top 3)

 
Select your preferred program dates (Top 3)

In 2017, the Health Innovation program will be taking place in Cape Town, South Africa.
 
1st Choice *


 
2nd Choice *


 
3rd Choice *


 
The program you selected is currently full.

 
What are three words that symbolize what you hope to gain from your experience? *

 
What are three words that symbolize what you hope to give during your experience? *

 
Why do you want to volunteer with OHS? *

Please respond in 200 words or less.
 
Name 3 peers who can attest to your integrity and ability to serve as a global mentor in Cape Town, South Africa.

(They will receive a simple, 3 question multiple choice survey).
 
Peer 1: First Name *

 
Peer 1: Last Name *

 
Peer 2: First Name *

 
Peer 2: Last Name *

 
Peer 3: First Name *

 
Peer 3: Last Name *

Thank you for submitting the Volunteer Application! A member of our team will be contacting you within 5 business days to discuss this opportunity further. 
Tap the button below to learn more about the experiences of past mentors. 
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Please click on the button below to be redirected to our 2017/18 application.
Take me there!
Thank you for your interest in One Heart Source!
All applicants for our Service-Learning programs must be at least 18 years of age prior to program start. If you'd like more information, please contact admissions@oneheartsource.org
Thank you for your interest in our 2017 programs! You can expect a next step notification in Fall 2016.