Contact Information

Thank you for your interest in starting a Project HEAL Chapter at your school and/or in your community.

Please note that in order for your Chapter application to be considered, you must fill out this application in full. 

This application should take you between 20-35 minutes to complete. We look for Chapter Leader applicants who demonstrate passion, motivation, and zeal for our cause. As this is a high-level volunteer position, extra time and consideration are provided in reviewing each application.

If you are interested in applying to volunteer with Project HEAL, but do not want to start a Chapter, please fill out our general volunteer application. Please reach out to Ali Hougnou (, Project HEAL's Director of Volunteer Services with any questions.

Thank you, again, for your interest in Project HEAL!

* 1. Contact Information

* 2. Age

* 3. Date of Birth

* 5. Occupation

* 6. School/Year/Major (if applicable)