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Community Outreach

Alternative Breaks & Immersion Programs

First Name
Last Name
Peoplesoft #
Sex:
Select an Alternative Break:


Hurricane Relief Trips, please follow directions on trip description page.
Winter Break Relief Trip || Spring Break Relief Trip
Local Address
Street:
City:
State:
Zip:
Permanent Address
Street:
City:
State:
Zip:
Email
Local Phone
Home Phone
Student Status
Graduate Undergraduate
Major
Minor
Expected Graduation Date

Please answer the following questions.

What are you interested in participating in the alternative break?

What are your expectations of this trip?

Have you ever worked or volunteered with a group or non-profit organization before? If so, in what capacity was your involvement?

In your opinion, what are the most important social, economic, or political issues facing society in the United States?

What are your available meeting days and times?
(Example: Sunday after 6pm; Tuesday after 7pm)