Alternative Spring Break Application
Selection for the trip will be based on your Participant Application and Interview
Having a record of the following will remove an applicant from consideration:
Violent or Drug Crimes
Illegal Drug Violations
Violent Conduct Violations
Sex Crimes
Other incidents that raise concern
Main Application
Contact Information [Required]
Valid input:
- must be 10-15 digits long and may include only numbers,
- name@myschool.edu
hyphens, and spaces.
First name:
Middle initial:
Last name:
Email address:
Phone number:
Address:
City:
State:
ZIP:
Cumulative GPA (High School Cumulative if Freshman) [Required]
Year in School (1,2,3,4, etc.) [Required]
Student ID Number [Required]
Major [Required]
Gender
Date of Birth [Required]
Essay Question One
What motivated you to apply to be an Alternative Spring Break participant and what do you hope to learn? [Required]
Essay Question Two
Teamwork and group dynamics are an important part of an Alternative Spring Break trip. What strengths do you possess that will contribute to the
team's success? [Required]
Alternative Spring Break - Action in Atlanta provides the opportunity for one participant to take on the role and responsibility of Student Trip Leader.
The Student Trip Leader will receive $150 towards the cost of the trip.
Page 1 of 2 · Alternative Spring Break Application
The Student Trip Leader has the following responsibilities alongside the trip's advisors:
Co-Run Pre-Trip Meetings
Assist with Fundraising
Coordinate Participant Roles
Coordinate Re-Orientation Project
Assist with Reflections
Are you interested in being selected as a Student Trip Leader? [Required]
Valid input:
- Select only one choice.
[ ] Yes
[ ] No
Trip Leader
Essay Question Three
What leadership experiences have you had that have prepared you to lead your peers? How will you use these experiences as a student trip leader?
[Required]
If Selected, I agree to: [Required]
Pay the entire Alternative Spring Break fee, even if I do not attend for some reason.
I acknowledge that if I use drugs or alcohol while on the trip, I will be sent back to USFSM immediately - at my own expense.
If selected, I acknowledge that I must provide proof of insurance and other medical information, as needed.
My final payment for this trip will be due on Monday, February 29th
Valid input:
- Select only one choice.
[ ] I Agree
Signature (First and Last Name) [Required]
By electronically signing this application, you are giving permission to the Office of Student Engagement to check your University discipline records, enrollment status, and
Grade Point Average.
Participant
If Selected, I agree to: [Required]
Pay the entire Alternative Spring Break fee, even if I do not attend for some reason.
I acknowledge that if I use drugs or alcohol while on the trip, I will be sent back to USFSM immediately - at my own expense.
If selected, I acknowledge that I must provide proof of insurance and other medical information, as needed.
My final payment for this trip will be due on Monday, February 29th
Valid input:
- Select only one choice.
[ ] I Agree
Signature (First and Last Name) [Required]
By electronically signing this application, you are giving permission to the Office of Student Engagement to check your University discipline records, enrollment status, and
Grade Point Average.
Page 2 of 2 · Alternative Spring Break Application