Volunteer Form

SPRING 2019 | DENTAL OUTREACH | DOMINICAN REPUBLIC

Saturday, March 23 - Friday, March 29, 2019

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World of Smiles Inc, with support from the New York Academy of Dentistry and in collaboration with Rutgers School of Dental Medicine, welcomes you to our next outreach to the schools of Fundacion MIR in La Romana, Dominican Republic.

We are happy to have Rutgers University School of Dental Medicine students along for the third time and some new faces from the NYAD. I am sure that you are all excited about the prospects and we look to exceed your expectations. There is a lot of hard work ahead but it will be very rewarding!  

To ensure that you have no limitations or hindrances to travel and are able to fully participate in the outreach, please complete the volunteer contact form below:

Name *
Name
Cell Phone Number
Cell Phone Number
Address *
Address
Emergency Contact *
Emergency Contact
Phone *
Phone
Medical Information