Registration for Trip Departing May 12th, 2018 is now open. Registration closes March 1st, 2018. If you have any questions, please don’t hesitate to contact Dr. Shupp at aaronshupp@helpinghandsusa.org

You can secure your place by making a non-refundable $250 USD deposit upon registration. Full payment is due by March 15th, 2018. Please complete the form and enter payment information. You will have the option to pay deposit only or full course fees 

 

 
 
Name as it appears on passport *
Name as it appears on passport
Date of Birth *
Date of Birth
Gender *
(needed for international travel)
Home Address *
Home Address
Home Phone *
Home Phone
Cell Phone
Cell Phone
Name, Relationship, Phone, Email

After the form is submitted. Follow through to payment. You can secure your place by making a non-refundable $250 USD deposit upon registration. Full payment is due by March 15th, 2018. Please complete the form and enter payment information. You will have the option to pay deposit only or full course fees