2023 Guatemala Medical Trip Signup

Name

First Name

Last Name

Date of Birth

Gender (As listed on your passport)

Phone Number

Name of Degree Program

Current Year in Program (1st year, 2nd year, etc.)

What are you hoping to gain from this experience?

Are you comfortable sharing a room with others of the same gender?

Yes

What is your preferred lodging?

Homestays are recommended for an integrated cultural experience but alternative lodging can be provided for an additional fee.

Home stay

Hotel and/or Hostel

A mix of both as described on the website.

Is there anything else you would like us to know about you?