Toggle navigation
Afro-European Medical and Research Network
(AEMRN)
Home
About Us
About Us
AEMRN around the World
Our Team
Projects
Projects
Donations
Mobile Clinics
Membership
Membership
Volunteers
Events
News
News
Publications
Gallery
Gallery
Archive
AEMRN in Videos
Mobile clinic videos
Contact Us
Home
About Us
About Us
AEMRN around the World
Our Team
Projects
Projects
Donations
Mobile Clinics
Membership
Membership
Volunteers
Events
News
News
Publications
Gallery
Gallery
Archive
AEMRN in Videos
Mobile clinic videos
Contact Us
WorkCamps
Home
WorkCamps
WorkCamps Form
First Name
*
Last Name
*
Sex
*
---
Female
Male
Date of Birth
*
Nationality
*
Present Occupation
*
Area of Specialization
*
Address
*
City
*
Postal Code
Country
*
Home Phone
Work Phone
Mobile Phone
Email
*
Emergency contact (phone number) / name of the contact person whilst you are away on the project:
Passport number (Check visa requirements for chosen project location) :
Reason(s) for participation in workcamp:
*
Give details of your voluntary / community work experience including work camps if applicable:
*
What do you think you can contribute to the workcamp as a volunteer? *:
*
choice of mobile clinics
*
---
Southern Africa I
Western Africa I
Eastern Africa - II
Western Africa III
Western Africa II
Estimated time you can afford to volunteer at the Workcamps:
*
Mother Tongue
*
Other Language
*
Why do you choose this particular workcamp? :
*
What do you expect from it?:
*
X