Learn To Live | Application Form

Full Name*
First Last
Phone Number*
Email*
Address Details*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Nationality
Sex*
Birthday!*
MM slash DD slash YYYY

Clean Water Design & Build Projects
The Water Project Design & Build runs alongside our Indonesian Health Initiative in North Sulawesi Indonesia.
We’re interested in what particular set of skills can you bring to the water project! Tell us about the kinds of projects have you created / built / planned / or collaborated on in the past?*
Tell us how you would handle the following situations:
Due to the remote locations of some of the water projects, you may be living in a village with your team members for a week away from the medical team, wifi, or even a store that serves cold drinks.*
You’ve been working in the sun for several hours and feel a bit lightheaded. What do you do?*

Global Health Student Program
The Global Student Health Program runs alongside our Indonesian Health Initiative in North Sulawesi Indonesia. This is a wonderful opportunity for health science students to work alongside international medical professionals, gain community health experience, and learn about global health priorities in challenging environments.
Academic Institution*
Field of study/concentration/ major*
At what stage will you be in your degree at the start of the program?*
Please describe the placement or field relate work opportunities you have experienced to date.*
Why do you want to work on a placement in Indonesia?*
What skills/attributes can you bring to the program?*
How will you prepare for your placement with LTL Indonesia?*

Laos Maternal & Child Health Program
The Laos Maternal & Child Health Program runs for 10 days during January in Mok Mai, Laos - 8 hours outside of Vientiane. This program helps improve the health of mothers & babies, educate young women & men, and trains new ultrasound technicians.
Real quick, just so we can note it, can you let us know if you are any of the following:*
- Nurse
- Midwife
- Maternal Child Health Specialist
- Doctor
- Health Educator
Tell us about your roles in the health and how long you’ve been practicing.*
Tell us about some of your experiences in health education or patient education*
Do you have any experience with ultrasound machines?*
- Yes
- No
Please describe your experience with ultrasound machines*

LTL Scan
The LTL Scan program runs concurrently with existing LTL programs. This program is run by two ultrasound specialist and provides a week long curriculum on sonography related to pregnancy and trauma (FAST).
Are you a healthcare professional? Tell us about your roles in the health and how long you’ve been practicing.*
Do you have any experience with ultrasound machines?*
- Yes
- No
Please describe your experience with ultrasound machines
What is your experience teaching medical education*

Application Form