Name: *

Date of Birth: *
Example: 08/24/1987

Gender: Female Male *

Email: *

Phone Number: *
Example: 813-974-3180

Major / College: *
Example: Civil Engineering, College of Engineering

USF ID: *

Student Status: Freshman Sophomore Junior Senior Graduate Student Staff Faculty *

Please answer the following questions:

If you are 21 years or older by April 1, 2008 (with a clean driving record), would you be willing to drive a van during your Alternative Weekend trip? Yes No N/A *

1. Do you have any allergies or any other medical conditions that may require special accommodations for this trip? If so, please list them here:
*

2. Have you ever participated in an Alternative Break (Weekends or Spring Break) before? If you have, when and where did you go?
*

3. Why should you be chosen to be a participant for Alternative Weekends? Tell us things about yourself that describes your spirit for service:
*

4. Much of the success of Alternative Weekends is dependent upon group dynamics.  What role would you play on a trip to help build group dynamics of your team as they participate in service?
*