Trip Preference Form

Please note that all dates are subject to change and/or cancellation due to multiple factors, including COVID-19 and possible 14-day quarantines with some mission locations.

First Name *

Last Name *

Email Address *

Serving Position Serving Position

Surgical Specialty (Surgeons Only)

Please rank your interest and availability for each trip using the dropdown menus below. If you are not able to participate in a trip, select "Unavailable".

Mexico 1 (January 14 - 18, 2023) - COMPLETED

India (February 16 - 26, 2023) - CANCELLED

Belize 1 (April 14 - 17, 2023) - COMPLETED

Mexico 2 (June 3 - 6, 2023)

Zimbabwe (September 14 - 24, 2023)

Belize 2 (November 3 - 6, 2023)

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Trip Preference Form

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