DART Interest Form

If you would like to learn more about our DART program—what we do and how to sign up—please fill out this form. We will contact you to answer your questions and provide more information.

Name(Required)

First Last

Email Address(Required)

Email Address Confirm Email Address

Please send me email updates about Samaritan’s Purse initiatives (you can withdraw your consent at any time)

Phone Number(Required)

Preferred Method of Contact

Phone

Please choose one of the options below

Interested in medical position

Interested in non-medical position

Legal Working Status(Required)

Canadian Citizen

Permanent Resident

Temporary Work Permit

None of the above

Occupation

What is your home church?(Required)

How did you hear about us?

Thank you so much for your interest, please click submit and a member of our team will be in touch.

The Samaritan’s Purse Canada (SPC) retains your personal information as confidential. The information you provide will be used to register for the event and inform you of our programs and projects, to help encourage you spiritually, and to provide you opportunities to support our work. For further information on how we use your information please review our terms of use and privacy policy. Please contact SPC at 1.800.663-6500 or email [email protected] if you do not want your information used for the purposes described with links on terms of use and privacy policies.

STAY IN THE KNOW!