Languages Spoken: (mother tongue first)
(This information will only be used to suggest touring options, etc. that are relevant for you)
Country of License:
Are you a member of a Dental Association/Academy?
Number of Hours per Week:
Dental Clinic Address:
Do you treat children?
Approx. percentage of practice treating children:
How did you find out about DVI?
News articles or Brochures
Did a specific colleague refer you to DVI?
Preferred Volunteering Dates:
(note: apartments at DVI are available from Friday to Friday)
Friday of Arrival – First choice: Friday of Arrival – Second choice: Friday of Arrival – Third choice:
Number of weeks available to volunteer:
How many family members are joining you:
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Dental Volunteers for Israel - DVI
Mekor Chaim Street 29, Jerusalem, 9346534 Israel