Christ the Healer Application Form


Required Documentation:

2018 Christ The Healer Application Form

Mission Dates 2018

  January 21-27
  April 21-28
  July 28- Aug. 4
   
   -------------------

Registration Fee:
  $150 per person
  Your registration will be finalized upon the reception
  of the fee.*(registration fee is non-refundable)


  • Please make check payable to: 
    Christ the Healer

       -------------------

    *** ALL DOCUMENTATION
    NEEDS TO BE NOTARIZED PER TRIP ***

    Copies of Your:
      1. Medical Diploma
      2. Current Medical License
      3. State Certificate
      4. American Board Certificate & License
      5. Updated CV
      6. List of medicines for the mission
  •   7. Copy of Passport

    *Please mail all documentation to the office no later than
     60 days prior
     to the trip. 

    Office Address:
      1000 Howard Avenue, Suite 1213
      New Orleans, LA 70113


       -------------------

    *** REQUIRED - Travel Registration ***
    Please register with US Government before each trip
    https://travelregistration.state.gov
► Email 
► Name: 
► Address: 
► Phone Numbers: 
► Mission Date: 
► Religious Affiliation: 
► Medical Profession: 
► Emergency Contact Name and Number, Recommended by, Languages you speak, Other important information: 
    

Search

Social Media

                      

YouTube

Share Info - Google Drive