Global Relief Application

Please complete and send the following application to receive medical kits that have a retail value between $25,000 and $40,000. The application must be received 4 weeks prior the your trip's departure date. Each traveling volunteer will hand transport these kits to developing communities. Each kit counts as one of the two 'check in' luggage pieces and come with documents to help clear customs upon arrival. It is recommended that the people you deliver to meet you at the airport and provide back-up in the event customs attempts to hold the kits.

By completing this application, it is understood that these supplies are gifts of the people of the USA and must be distributed WITHOUT COST to those in need. It is also agreed that any PR, newspaper or magazine articles, web sites, TV news or other mode of PR MUST include the following statement:
"Medical supplies provided through Operation Serving Children, a 501C3 local to global educational child relief agency (www.OSCrelief.org)

Complete the following questions printing clearly:

Number of kits requesting:

Name of clinic receiving supplies:

Address of clinic:

Phone of clinic:
Name of dispensing medical personnel at this clinic:

Describe the type of population clinic is located: size, level of poverty, running water available?, sewage present?, rural/urban?

What is the goal of your trip?

List any other organizations involved in this trip:

It is required that supplies be kept in a cool, dry locked facility, is this possible?

What are the 5 major health problems of the community?

Estimate the number of people to be served in this trip:

Your signature and agency name, address, phone:

Name address/phone of where you want the kits delivered.

Date of departure for this trip:

Please print and mail to OSC at 5317 Fruitville Rd. #105 Sarasota, Fl 34232
or fax to 941-378-9755