APPLICATION FORM

WHICH ACTIVITY(IES) ARE YOU INTERESTED IN VOLUNTEERING AT?
Please note that expedition volunteers must be graduated healthcare professionnals (physician, nurse or psychosocial professionnals) or journalist, photographer or blogger. *

VOLUNTEER INFORMATION

Last name *

First name *

Birthdate * +

Occupation

Address

City

Postal code

Country *

Canada

United States

Other: Other:

Province *

Region *

Telephone *

Mobile

Email *

Preferred language of correspondence *