Dow Organ Support Society (DOSS)

Name*

Email*

Phone Number*

Date of Birth*

University Campus*

Year of Study

Why do you want to join DOSS?*

Do you want to pursue transplant surgery as a career option? If so, how do you think DOSS can enable you to achieve this career goal? (optional)

Which area would you like to contribute to?*

How much time can you commit per week?

Do you have any experience with Public Speaking, Event Organization or Digital Advocacy?*

Are you comfortable discussing organ donation with different audiences (medical students, general public, and healthcare professionals)?*

Do you consent to being contacted for volunteering opportunities and society events?*

Yes

Do you agree to abide by the rules and responsibilities of the Dow Organ Support Society (DOSS) if selected.*

I Agree