APPLICATION PACKET. Jesus, I Trust In You!

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1 APPLICATION PACKET The St. Laurence Parish Mission Advocacy and Promotion Program In Cooperation with the Diocese of Laredo, Laredo, Texas Jesus, I Trust In You! Medical & Spiritual Mission Diocese of Laredo 2013 November 2-9, 2013 Organized, Managed, and Conducted By (a 501(c)(3) nonprofit charitable healthcare provider corporation)

2 MEDICAL MISSIONARIES OF DIVINE MERCY 3100 SWEETWATER BOULEVARD SUGAR LAND, TEXAS Jesus, Phone: Fax: Cell: Pray for Us, I Trust In You cordellmmdm@windstream.net Corp. cordells@mmdmusa.org. O Merciful Mother July 25, 2013 Dear Missionary Friends, Thank you for your interest in participating in our 2013 Laredo Medical Mission which is advocated and promoted by St. Laurence Parish and the Diocese of Laredo. Enclosed you will find application information and requirements for the medical mission trip scheduled for November 2-9, Also enclosed is an application form. We hope you will consider joining us in this tremendous corporal and spiritual work mercy. When you have made a decision to join us, please return the completed application form along with at least half ($400) of the total $800 Missionary fee to guarantee your position on the mission team. Those who do not submit this portion of the fee will be processed on a first come first served basis. If you are applying as a Health Care Professional, please provide, along with your application form, notarized copies of your current professional license(s), certificates or practice permit(s). Please do not send us your originals, since we cannot assume responsibility for them. Mail your application to the address below or drop it off at St. Laurence Parish Offices. Application and Registration Group 3100 Sweetwater Boulevard Sugar Land, Texas Applications will be reviewed and candidates accepted before registration forms will be issued to the candidates. An important Information Meeting will be held at St. Laurence Parish in early August. Watch the church bulletin and listen to Mass announcements for location, time and date. We will show a medical mission presentation, have lay and ordained missionaries share their experiences and answer any question you may have regarding the mission. If you miss this meeting, please send your questions by and they will be answered (cordells@mmdmusa.org). Or you can call Jean Fontenot ( ), Elsa Poole ( ), or Cordell St. Cyr ( ). All individuals interested in learning about the mission project or in participating in the mission project are encouraged to attend. Thanks for your interest in our missions of corporal and spiritual works of mercy. Cordell Cordell J. St. Cyr, Mission Director Chairman of the Board

3 LAREDO VOLUNTEER APPLICATION FORM MEDICAL MISSION PROJECT TO LAREDO, TEXAS w/diocese OF LAREDO Name(s) You Spouse 1st Date App. Rcv d Street Address Day Ph.. Night Ph. P.O. Box/Appt. No. City, State & Zip Name of Parish/Church Location of Church Occupation Fax No. Cell Ph. No. 1. Have you participated in medical mission service work in the past? Yes No 2. Are you a certified/registered health care professional? Yes No 3. If 2. is Yes, name the specific profession? 4. Answer only one of the following statements: a. I can afford the entire $800 Missionary Registration Fee? Yes No b. I can afford a $400 Fee & count on family and friends for the other $400. Yes No c. I can put together $400 of the fee and need a co-sponsor for the balance! Yes No Each Volunteer must contribute $400 toward fees from their funds or from friends & family before MMDM will help find a sponsor for you! Ordained Clergy & Religious Are the Only Exception! 5. Do you speak Spanish? Yes No, Fluently? Yes No Write? Yes No 6. How could you serve the Medical Mission effort? Circle one or more of the following categories: Trip Trail Boss /Logistics Manager Translator/Interpreter Registration/Triage Manager / Bilingual Dr. of Chiropractic Medical Doctor / Adult Ailments Registered Nurse Practitioner Van Coordinator / Renter Priest / Deacon Catholic Registration/Records Coordinator / Bilingual Chiropractic Assistant Medical Doctor / Children Ailments Registered Nurse/Triage Driver/Mechanic Chaplain s Assistant Catholic Triage/Doc-Patient Coordinator/Bilingual Physical / Occupationl Therapist Medical Doctor / ENT Registered Nurse/ ENT Food Service Coordinator Eucharistic Minister Catholic Triage Nurse Bilingual Preferred Ophthalmologist / Optometrist Registered Nurse/ Ophthalmology Dr. of Dentistry Medical Technician Medical Assistant Dermatologist Dental Technician Pharmacist / Coordinator Pharmacy Technician or Pharmacy Aid Health Educator Bilingual Preferred Photojournalist/ Document Events Site Coordinator/ Crowd Control Prayer Leader / Catholic / Bilingual Triage/Lab Technician Optometrist Optician/Vision Technician Dental Hygienist Unskilled Dental Assistant Jack of All Trades 7. Are you in good general health? Yes No Are you on any medication? Yes No If No to general health or Yes to medications, Please explain! Do you have any special dietary needs General Alert Regarding Mission Working Conditions: You must be able to withstand the rigors of long workdays, temperatures from 45 O F to 100 O F. If you have a heart, lung, digestive, muscular, neurological or other health condition, consult with your doctor to assure that the work would not compromise your health or life. Participation is at your own risk. A Waiver of liability is required. A doctor s note may be helpful in any medical emergency. May the Good Lord guide you in your decision. 3_D%202013%20Volunteer%20Application%20Form[1] 2/22/09 1 OF 1 Medical Missionaries of Divine Mercy

4 MEDICAL MISSIONARIES OF DIVINE MERCY 3100 SWEETWATER BOULEVARD SUGAR LAND, TEXAS Jesus, Corp. Ph Cell Pray for Us, I Trust In You s: Corp. Info. medicalmissions@mmdmusa.org Proj. Info. cordells@mmdmusa.org O Merciful Mother RECOMMENDED IMMUNIZATIONS FOR VOLUNTEERS DIOCESE OF LAREDO MEDICAL MISSION, November 2-9, 2013 According to our team doctors, you should have the following: Tetanus, Td (tetanus-diphtheria) or Tdap (tetanus-diphtheria-acellular pertussis) within the past ten years. If you need this vaccine, Dr. Byrd recommends the Tdap (brand Adacel). Hepatitis A Hepatitis B (if you are a health care worker) Measles, Mumps, Rubella and Varicella (chicken pox) (If you have had these diseases you do not need the vaccines) Flu Shot strongly advised but not required All healthcare workers who work in direct contact with patients are encouraged to have an annual tuberculosis skin test. We will try to offer these shots at St. Laurence at some time before the mission and get the best price possible. You might check with your insurance to see if they will cover the cost. Please advise the mission applications and registration group of your needs so we can be sure to have the medications on site. It is recommended that you check with your personal physician to determine which vaccinations are appropriate for you. Sincerely, your brother in Christ, Cordell Cordell St. Cyr, Mission Director Chairman of the Board May the Good Lord bless you, all whom you love and all whom we are called to serve.

5 July 25, Sweetwater Boulevard Sugar Land Texas VIRTUS PROTECTING GOD S CHILDREN REQUIRED TRAINING BY ARCHDIOCESE OF GALVESTON/HOUSTON and DIOCESE OF LAREDO FOR ALL VOLUNTEERS FOR THE 2013 LAREDO MISSION PROJECT Dear Volunteer, All active priests, deacons, employees, and volunteers who interact with children and youth must attend the Protecting God s Children workshop, presented by VIRTUS. This three-hour workshop is held in several parishes in our area at various times. You can find scheduled sessions at You will not be able to participate in the mission program without it. For those who received VIRTUS Training during the period from 2003 to and including 2005, you must take the refresher course Keeping the Promise Alive. It is designed to identify and reinforce the teachings in the original Protecting God s Children Program. This refresher course is mandatory for all who will be working around children. Your Option is the take the present Protecting Gos d Children Program. You will not be able to participate in the mission program without theither. You must pre-register to attend any of the sessions. The simplest way to do this is via VIRTUS online at Click the yellow link labeled Registration on the left side of the screen. Choose the Archdiocese of Galveston-Houston from the pull down menu and click Select. You can now choose to begin the registration process, creating your own user id and password. If you have any questions about the process, please contact Tony Oltremari at St. Laurence (281) If you do not live in the area of the Archdiocese of Galveston-Houston, you must find a session in your area and forward a copy of your participation certificate to: Application and Registration Group 3100 Sweetwater Boulevard Sugar Land, Texas or Drop Off Your Application at St. Laurence Church Office If you have attended this workshop since 2006, you need NOT attend again. We do, however, need you to send us either a copy of your certificate of attendance or a printout from the Virtus website, which indicates course attendance and containing the date and location of your attendance. Sincerely, your brother in Christ, Cordell Cordell St. Cyr, Mission Director 5_D%202013%20Required%20Virtus%20Training%20for%20Volunteers[1] 1 of 2

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