Application Instructions:   

1)   Please complete application and send with check made out to “Beyond Partnership” to PO Box 5180, Sacramento, CA  95817-0180.  Application deadline February 20, 2012.

2)  Licensed Health Care Professionals or paraprofessionals must send the following items with the application.  These are required by the Nicaraguan Health Department.

-Notarized copy of your current practice license (please make sure license will be current for dates of clinic, otherwise renew now)

-Notarized copy of your resume’ or curriculum vitae

3)  A deposit of $100 is required with application

4)  $800 is due by March 1.  Balance is required by April 5, 2012.

5)  All payments are tax deductable and should be made out to “Beyond Partnership”

6)  Donors, other than the applicant, should include an address for a tax deductable receipt.