Application Form & Agreement
Preferred name (First and last):
Birthdate (day, month, year format example: 10Jan1991):
Cell phone number:
Email address:
Graduation year:
select one
2016
2017
2018
2019
Major:
Gender:
select one
Female
Male
Prefer not to answer
T-shirt size:
select one
Small
Medium
Large
X-Large
XX-Large
Are you studying abroad this year?
select one
No
Yes, fall semester
Yes, spring semester
Will you be 20 or older before first choice trip and willing/able to drive a trip minivan?
select one
Yes
No
If you will be 20 or older, have you had SNC’s Defensive Driving course?
If 20, select one
yes
no
Are you in good standing with the college?If you are currently on disciplinary probation with the college, you are unable to attend a trip.
select one
yes
no
Have you been on an SNC service trip before?
select one
yes
no
Please select your top choice of trip you are applying for:
Select Top Choice
Environmental Justice (Long weekend)
Children's Medical (Winter-Tennessee)
Children's Medical (Winter-Iowa)
Urban Education (Winter)
Urban Poverty (Winter)
HIV/AIDS (Winter)
Immigration and Refugee (Winter)
Urban Youth (Winter)
Children's Medical (Spring-Tennessee)
Urban Education (Spring)
Affordable Housing (Spring-Christmas in Action)
Affordable Housing (Spring-Habitat for Humanity)
Urban Poverty (Spring)
Friends with Disabilities (Spring)
Why are you interested in going on your first ranked trip?
Please select your second choice of trip you are applying for:
Select Top Choice
Environmental Justice (Long weekend)
Urban Education (Winter)
Urban Poverty (Winter)
HIV/AIDS (Winter)
Immigration and Refugee (Winter)
Urban Youth (Winter)
Urban Education (Spring)
Affordable Housing (Spring-Christmas in Action)
Affordable Housing (Spring-Habitat for Humanity)
Urban Poverty (Spring)
Friends with Disabilities (Spring)
Why are you interested in going on your second ranked trip?
Please select your third choice of trip you are applying for:
Select Top Choice
Environmental Justice (Long weekend)
Urban Education (Winter)
Urban Poverty (Winter)
HIV/AIDS (Winter)
Immigration and Refugee (Winter)
Urban Youth (Winter)
Urban Education (Spring)
Affordable Housing (Spring-Christmas in Action)
Affordable Housing (Spring-Habitat for Humanity)
Urban Poverty (Spring)
Friends with Disabilities (Spring)
Why are you interested in going on your third ranked trip?
If not chosen for one of your top three choices, would you be interested in going on a different trip?
select one
Yes
No
If yes above, please provide details on the dates you would be available.
I understand that the trip fee is a commitment upon acceptance of application and will be due within one week of application acceptance.
select one
yes
no
What are your fears or concerns for this trip?
What skills do you have (fundraising, cooking, urban travel, etc.) that will contribute to your group’s success?
What experience do you have with diversity, social justice, and/or service in the area(s) for which you are applying?
What do you expect to learn from your trip experience?
TRIPS interviews will be held Monday, October 5, 2015 in the evening. Will you be able to attend?
select one
Yes
No
No. Because I am currently studying abroad
Trip Agreements
**Please carefully review each of these items before responding.
1. Meetings - Attend all pre-trip, on-site, and post-trip meetings and activities. Exceptions to this may be granted on a case-by-case basis by the Trip Leader and only for extenuating circumstances.
Select after reading text above.
I have read and agree to the meeting expectations.
2. Liability - Behave in ways that are responsible, mature and representative of the best of St. Norbert College. This means compliance with all applicable state, federal, and international laws as well as the St. Norbert College code of conduct. This includes the no alcohol policy during college-sponsored events. Ignorance of a law is not an excuse or defense. If your behavior is unacceptable or in violation of this agreement, the Trip Leader (in consultation with TRIPS staff) may terminate your participation in this trip. Termination means you must find your own way home at your own expense (a driver will escort you to the nearest transportation terminal), your lodging and reservations will be canceled, and you will not receive a refund of any of your trip fees.
Select after reading text above.
I have read and agree to the liability expectations.
3. Participation - Participate in activities that help build community, support learning and allow for personal growth. This may include organizing community meals, leading reflections (i.e., group journals, ecumenical prayer, and discussions), planning games or outings, etc. Stay with the group at all times during the trip.
Select after reading text above.
I have read and agree to the participation expectations.
4. Reorientation - Develop and implement a project to educate others about your experience and what you have learned. Past projects included a video, a slide show, a picture display, assisting with recruitment, doing presentations, etc. Projects must be completed by the end of the semester in which you participated on the trip.
Select after reading text above.
I have read and agree to the reorientation expectations.
5. Payment - The full trip fee is due to the TRIPS staff by the TRIPS orientation meeting. Payment can be made by cash or check to SNC. Additional fundraising is required to help cover all trip costs. TRIPS fees and fundraising donations are not refundable.
Select after reading text above.
I have read and agree to the payment policy.
6. Cancellation – Due to the changing nature of the needs and services provided by the non-profit partners we work with around the country, the trip itinerary and sites are always considered tentative. In the unlikely event that a site cancellation results in the cancellation of the trip, all fees will be refunded. Donations cannot be refunded.
Select after reading text above.
I have read and agree to the cancellation policy.
Answering the 6 areas above affirmatively indicates my agreement and understanding of the responsibilities I am undertaking as a trip participant. I also personally assume any risks involved in activities outside of the trip program. Submitting this trip agreement form indicates that I have carefully read and agree to the above conditions.
If you are in need of financial assistance to help with the cost of the trip, please email Jennifer Nissen to obtain an application form.
Turning Responsibility into Powerful Service (TRIPS) challenges students to participate in a week or more of personal growth through life-changing service in areas throughout the United States.
Turning Responsibility into Powerful Service (TRIPS) challenges students to participate in a week or more of personal growth through life-changing service in areas throughout the United States.
Turning Responsibility into Powerful Service (TRIPS) challenges students to participate in a week or more of personal growth through life-changing service in areas throughout the United States.
Turning Responsibility into Powerful Service (TRIPS) challenges students to participate in a week or more of personal growth through life-changing service in areas throughout the United States.
Turning Responsibility into Powerful Service (TRIPS) challenges students to participate in a week or more of personal growth through life-changing service in areas throughout the United States.
Turning Responsibility into Powerful Service (TRIPS) challenges students to participate in a week or more of personal growth through life-changing service in areas throughout the United States.
