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Would you like to become a DAISI member?

DAISI® membership is open to doctors, medical students, nurses or non-medical volunteers who have volunteered their services with DAISI in the South-Pacific Islands. 

If you would like to become a member, please complete the contact form below and indicate when and where and how long you have volunteered in the South-Pacific Islands.

    Your Name (required)

    Your Email (required)

    Your Mobile

    Your Postal Address

    Select Country

    Your preferred referee's name (preferably a current DAISI member or colleague or superior at work)*

    Your referee's position (preferably a senior member of staff of supervisor)*

    Your referee's mobile number *

    Your second referee's name (can be your colleague or superior at work)*

    Your second referee's mobile number *

    Your second referee's position (preferably a senior member of staff of supervisor)*

    polo-shirt

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    It is customary (but not compulsory) for DAISI volunteers and member to identify themselves on volunteer trips by wearing the DAISI logo-embroidered polo shirt and cap as well as a DAISI photo ID badge.

    Would you like to purchase a DAISI logo-embroidered polo shirt?($60 delivered)

    Polo Shirt Type

    Polo Shirt Size

    Select the number of polo shirts

    Would you like to purchase a DAISI logo-embroidered cap?($30 delivered)

    Select the number of Caps

    Would you like to purchase a DAISI photo ID card with lanyard? ($20 delivered)

    Please describe your volunteer work in the South-Pacific Islands with DAISI to date.

    Terms & Conditions for Volunteering & DAISI Membership

    I confirm that the above entered information is accurate. I confirm that I have engaged in volunteer work with DAISI in the past, and am committed to DAISI's philosophy as stated in it's Constitution.

    Have you read and agree to abide by the above Terms & Conditions for membership and the DAISI® constitution?
    YesNo

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