Fall Break Leader Information

Fall Break: October 26-29
$25 dollar fee charged to student account: this will cover service trip expenses and t-shirt
 

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* 1. Name:

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* 2. ID Number: 

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* 3. Email:

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* 4. Phone Number:

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* 5. Year in School:

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* 6. Age at time of trip?

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* 7. T-Shirt Size:

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* 8. Reference Name:

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* 9. Reference Phone Number:

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* 10. Reference Email:

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* 11. Do you have someone specific in mind as a co-leader? If so, who?

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* 12. What social issues are you interested in working with?

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* 13. Do you have an idea for a location for your service trip? (Must be under 6 hours)

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* 14. Why do you want to lead a service trip?

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* 15. What prior leadership experiences do you have that qualify you to lead a service trip?

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