Required Documentation - Power of a Nickel

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Required Documentation

Trip Application
Trip Deposit
Scholarships
Required Documentation
Make a Payment
Evacuation and Cancellation Insurance

REQUIRED DOCUMENTATION

All participants must complete this form. ALL DOCUMENTS MUST BE UPLOADED in .PDF FORMAT

Name *

First Name

Last Name

Trip Destination *

Copy of picture page of your passport. Make certain all numbers are easily read. *

Copy of your evacuation insurance ID card. (not the whole policy) *

Picture of yourself. (Provide a small file size) *

Copy of airline itinerary *

LICENSED HEALTHCARE PROVIDERS, please upload the following in a PDF format

Copy of your state license with expiration date.

Copy of your medical/dental/other school diploma.

Curriculum Vitae

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About

Our Board
History and Impact

Join a Trip

Trip Application
Pay Deposit
Make a Payment
Prepare to Travel
Required Documentation
Evacuation/Cancellation Insurance
Scholarships

Support

Donate
Events
Donate Medical Supplies
Join a Trip

Contact

Send an Email
Mail a Check:
4520 South Birmingham PL
Tulsa, OK 74105

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