Volunteer with Wills CAGO

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Wills Eye Global volunteer form

We welcome and appreciate the volunteer efforts of students and physicians at multiple levels of training. Please fill out the form below to inform us of your interest in getting involved with CAGO.

Volunteer Form

Name *

Institutional Affiliation *

Email *

Phone

Please specify level of training *

Please choose one

If fellow/attending physician: What is your sub-specialty. Please list below

Are you available for short or long-term interational travel? *

Yes

No

If yes: How long are you willing to work abroad?

What is the nature of your interest in working with CAGO?

Provide surgical training to residents at partner organizations

Give didactic lectures on a specific topic

Assist in curriculum development (remotely or in-country)

Become involved in clinical or public health research

Help coordinate outreach or screening events in Philadelphia

Other

(please select all that apply)

If other, you may enter additional information here

What sites are of interest to you?

Haiti (both the Haitian University Eye Hospital and Vision Plus Clinique)

Rwanda (both Rwanda International Institute of Ophthalmology [RIIO], Kabgayi Eye Hospital)

Kibuye Eye Hospital, Burundi

(please select all that apply)

How did you hear about CAGO?

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840 Walnut Street Philadelphia, PA 19107

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