US Application - Cura Brasil

First Name*

Last Name*

Email*

Address*

Street Address City State ZIP Code

Phone*

Date of Birth*

Profession

Profession*

Healthcare Professional
Student
Other

Specialty*

Current Education Level*

Profession*

Duration of Practice within Specialty*

Field of Study*

Duration of Practice Within Profession*

Prior Mission / Volunteer Experience*

Y
N

Location*

Role*

Organization*

Organization Purpose*

Prior International Experience*

Y
N

Location*

Purpose*

Do you have a Current Passport ?*

Y
N

Do you have a Current Brazilian Visa?*

Y
N

Are you fluent in Brazilian Protuguese?*

Y
N

Traveling with any family members?*

Y
N

If yes please list names below , each must submit an individual application and deposit , each child under 16 require an adult companion.

Any Special Handicap, Dietary or other information we should know?

Please read and sign our campaign contract & code of ethics.

Download a Copy

MISSION: Understanding that all of us are blessed with unique God-given talents, CURA Brazil brings together volunteers - healthcare and non-medical - from Brazil, the United States and other countries. We aim to serve the medical, psychological and spiritual needs of all who seek our care.

CODE OF ETHICS: Due to its mission CURA Brazil has adopted a code of ethics to guide its board members, participants and volunteers in their conduct while acting on behalf of CURA Brazil. The code of ethics contains information reflecting the nature of behavior CURA Brazil expects during the mission’s campaign and post-campaign trip.

This is an effort by the organization of CURA Brazil to create and maintain a standard of quality which gives ethical conduct the highest priority. This code will be updated and/or reviewed periodically.

Board Members, participants and volunteers shall

Make an effort to understand, respect and support participants, volunteers and patients from other cultures.
Contribute to the organization’s mission.
Contribute to the organizational culture of CURA which respects the individual contributions of the members, participants and leadership.
Provide credible leadership to the mission and organization’s work and goals without bias.
Provide professional and credible care without bias.
Uphold your specialty’s code of ethics and oath.
Be accountable for adhering to this code of ethics.
Honor commitments and promises to the best of your ability.
Honor and acknowledge contributions and talents from other individuals, organizations, and governments which help facilitate our goals and mission.
Act and behave in a positive light which upholds and promotes the efforts of the mission and organization.
Meet and maintain the level of professional excellence required by the Brazilian governmental agencies as well as your home country’s governing agencies.

COMPLIANCE, MONITORING, & REPORTING: The CURA Brazil Board of Directors is responsible for communicating this code of ethics to all volunteers and participants, and for ensuring its adherence at all times.

Ratified by CURA Brazil November 14, 2016.

I HAVE READ AND AGREE WITH THE CONTRACT & CODE OF ETHICS*

I AGREE

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Profession

Application Fee

step 1: complete form
step 2: sign agreement
step 3: submit $100 fee

trocar

para a inscrição brasileira

Profession

Application Fee

step 1: complete form step 2: sign agreement step 3: submit $100 fee

trocar

para a inscrição brasileira

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step 1: complete form
step 2: sign agreement
step 3: submit $100 fee