Application

Volunteer Application

* Indicates required field

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Email *

Do you have a valid passport? *

Name as it EXACTLY appears on Passport *

Passport Number *

Passport Issue Date *

Passport Expiration Date *

What type of team are you interested in?

Select one *

Mobile Medical Clinic Team Sustainable Work Project Team Board of Directors

Will this be your first trip with Lavi Project? *

Yes, this will be my first No, I have traveled with Lavi Project before

Any Additional Comments *

I agree to receiving marketing and promotional materials *

Submit