Medical Volunteer Application | Children's Surgery International

Currently we are only accepting medical applications for the following positions:

The experience and document submission requirements for medical volunteers are as follows:

You must be currently licensed as a Registered Nurse, Nurse Practitioner, CRNA, or Anesthesiologist, and submit proper documentation of this certification below.
- Operating room nursing applicants must have current tertiary operating room experience (not in an office).
You must have three years of recent nursing experience, preferably in a pediatric facility, as indicated in your resume or CV.
- Those without the above experience will be considered if they have done similar work in developing countries or have proven mission experience. Please specify this experience in your resume or in the “Other Comments” field.
You must submit the following (upload below):
- A current resume or CV
- Your current BCLS certification and nursing license. PALS or ACLS is recommended by not required.
- Two references with current phone numbers

First Name: *

Middle Name:

Last Name: *

Street Address: *

City: *

State: *

Zip Code: *

Home Phone: *

Work Phone:

Mobile Phone:

Fax:

Email Address: *

What is your birthdate?: *

Do you have a current Passport?: *

Yes

Passport expiration date:

Blood type:

How did you hear about CSI?: *

Additional Comments:

I'm interested in the following volunteer opportunities: *

Current Resume or CV: *

Proof of Current Licensure: *

PALS or ACLS Certification:

Please have no more than 1 personal reference.

Reference Name: *

Reference Phone: *

Reference Relationship: *

Reference Name: *

Reference Phone: *

Reference Relationship: *

Reference Name:

Reference Phone:

Reference Relationship: