TRAVELING AND GENERAL MEMBERSHIP APPLICATION

Application Deadline: Saturday, April 15th @ Midnight

Submit Application to

Qualifications to apply:

  • SDSU SON Student
  • Must be in good academic standing with the SON

PLEASE CHECK WHICH YOU ARE APPLYING FOR:

TRAVELING MEMBER

GENERAL MEMBER

GENERAL INFORMATION:

Red ID:
Full Name:
(first, middle, last)
*As shown on passport
E-mail:
Cell phone:
T-shirt Size:
/ Male size:
Unisex:
Female Size:
Birthday:
Major(s):
Minor(s):
Current semester in nursing program:
Need the international experience unit?
Planning to travel before or after brigade?
Do you have a location preference of departure for the trip? (SF, LA, SD)
Emergency Contact:
(name, phone#, e-mail, relationship)
Allergies:
Dietary Preferences:
(e.g. vegan, vegetarian, gluten-free)

TRAVELING MEMBERS PLEASE CONTINUE ONTO NEXT PAGE FOR FURTHER QUESTIONS

State your understanding of who Students HEAL is and our mission.
Special certifications/skills?
(CPR/BLS, EMT, Healing Touch, Massage Therapy):
BLS must be valid until Jan. 2018
Can you afford roughly a $2000 brigade? If not, explain how you plan to fundraise for the brigade.
And
Would you be able to pay the $50 new member fee by the first general meeting April 26?
(Please note that if you are unable to make the payment you risk losing your spot in the brigade if you are accepted).
Please answer the following:
  • Why do you want to join us and Starfish Volunteer in Thailand?
  • What experiences/skills have/do you have that will contribute to this brigade?
  • How much free time do you have (please state hours/week)
  • What do you think is the purpose of organizations like these?
  • If this is a passion of yours, why?

Be aware that as a member, you are required to contribute a lot of time to help fundraise over $10,000 worth of medications and be willing to help during events that will contribute to the success of this brigade. Are you willing to commit to this responsibility? Why? How?
If your fellow members were not participating in activities/events, as a member of HEAL, what would be your response?
Did you attend any HEAL events or information sessions in the past?
Are you interested in being a vital part of the Fundraising Committee? I yes, how will you contribute?
Would you be able to attend our first general meeting April 26 at 6pm?
And
Would you be able to give up one weekday (exact date TBD), bi-weekly, for general meetings/events?
Deposit Deadlines are as follows:
4/26 Wednesday- $50 one time member fee
Future deadlines after April are TBA, but will continue to be on a monthly Thursday basis.
You are responsible for meeting these deadlines. If you fail to meet deadline, a $10 late fee will be added to each day missed. If you cannot make the deposit 7 days after the deadline, you WILL BE DROPPED without refund. NO EXCUSES.
Additional comments/questions:
Being in a rural village does challenge some of our normal hygiene behaviors. Are you ok with adapting to these challenges?
This brigade is physically and mentally exhausting. How will you cope with this demand?
AND

Are you committed to remain positive and helpful in even the most demanding and draining situations?

How will applicants be chosen?

Applications are chosen based on a point system. Certain questions are worth 1-3 points. The most possible points is 33. The persons with the most points will then be selected and then the next and so on.

***If necessary, due to an equal amount of points between applicants, interviews will be conducted to determine the best suited applicant for the brigade. Scheduling of the interviews will be conducted on Monday April 17th.***

How will I be notified if I am chosen?

Chosen members will be notified via email the week of April 17th-21st. Each member is given 5 days to provide the initial deposit (by the first general meeting on Wednesday, April 26th). If any member denies their invitation, for any reason, on Saturday April 29th we will send out a mass e-mail/ text to those on the waiting list.

Members will be required to attend all events. If members miss more than 2 events or meetings with unexcused absences, they will be dropped from the brigade.

**PRIOR TO SIGNING APPLICATION PLEASE CONSIDER THE FOLLOWING CONTRACT THAT YOU WILL BE SIGNING AND HELD ACOUNTABLE FOR**

“______herby agree to demonstrate professional School of Nursing behavior at all times as a Student’s HEAL member. I am aware that as a traveling member, I am only permitted two unexcused absences from HEAL general meetings or other HEAL member events. I will respect my assignment to a committee and carry out tasks appointed unto me with dedication. I affirm that I can afford the finances involved with this experience. I will pay the $50 membership fee at the first general meeting and agree to pay late fees as designated by the HEAL faculty and leaders. If I cannot pay for the trip, or do not participate in events, expenses already paid will not be refunded. I acknowledge that I will need to be compliant with required medication regimens and vaccinations in order to attend this trip as a traveling member. I pledge to uphold all of these requirements.”

It is also crucial that as a traveling member you understand fully the mentally and physically draining responsibilities that accompany the brigade. This trip demands participation and cooperation for any task that is asked of you. It is necessary that you are a “team player.” You must understand that this brigade will put you out of your comfort zone. We will be traveling in rural villages and won’t have access to many accommodations that you are used to. If you are not able to accept any of the terms listed, you are unqualified for the brigade.

By signing this application, you have agreed to release your personal information for use by executive officers for the upcoming trip. You also agree that any money amount deposited to this trip is NON-REFUNDABLE.

Signature:

Date: