One World Surgery · Medical Missions Transportation Fee Online Donation Form

Medical Mission Trip Non-Standard Transportation Fee *

To pay your own or another volunteer's non-standard medical mission transportation fee.

Amount *

$200 - Honduras

$150 - Dominican Republic - Punta Cana

$100 - Dominican Republic - Santo Domingo

$60 - Dominican Republic - Juan Dolio

$50 - Dominican Republic - La Romana

$

Donation Schedule

Medical Mission Trip Dates *

If mission trip is not listed, please choose "Other dates" and add information in Special Instructions field below

Individual or Business/Organization *

Are you paying as an individual, or on behalf of a business or organization?

Individual

Business/Organization

Business/Organization Name *

Payor Name *

Prefix

First Name

Last Name

Suffix

Contact Information

Email *

Verify Email *

Phone *

Address *

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Special Instructions

Please enter the specific medical mission trip participant information here.

Keep in touch!

Please add me to the One World Surgery mailing list.

To make a donation by mail, send a check to One World Surgery, c/o SCA Health, 569 Brookwood Village #901, Birmingham, AL 35209. To donate by phone call 872-267-3846. For questions or to suspend a recurring donation, contact us at info@oneworldsurgery.org