Student Information

* 1. Contact Information:

* 2. Race/ethnicity, choose all that apply:

* 3. If you selected American Indian or Alaska Native, what is your tribal affiliation?

* 4. Education information

* 5. Personal information

* 6. This field trip includes hiking a total of 20+ miles over a significant elevation change, carrying a backpack of about 30 pounds, and camping in a remote region. Are you aware of these extreme conditions?

* 7. Do you have health insurance?

* 8. If you do have health insurance, please provide the name of your health insurance provider.

* 9. If you do not have health insurance, are you wiling to purchase a temporary travel policy during the field trip dates?

* 10. Please describe why you want to attend the SEEDS field trip to the Havasupai Nation, considering your educational and career goals and interest in exploring or pursuing a career in ecology and/or water sustainability.

* 11. Summarize your experience in ecology and/or water sustainability thus far (SEEDS activities, coursework, research or work experience, personal life experience), and how your experience can contribute to the field trip.

* 12. Please describe your ideas for remaining engaged in water sustainability after the field trip (in your SEEDS Chapter, home community, and/or with the field trip student group with representatives from across the western region).

* 13. Decribe how your participation would fulfill the mission of SEEDS, to promote diversity in the ecology profession.

Thank you for your interest in attending the ESA SEEDS field trip to the Havasupai Nation. Please contact Melissa Armstrong at with any questions.