VISION Spring Break 2016 Application
Application Checklist!
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Fill out Applicant Information below.
Answer all questions Answers must be typed and attached.
Read carefully and sign Applicant Agreement.
If applying for a Michael Patrick Keefe Scholarship, Loftus Scholarship, please attach to application.
APPLICANT INFORMATION
Full Name (First Middle Last):
Gender:
Year:
UST ID:
Date of Birth:
Cell Phone:
EMERGENCY CONTACT INFORMATION
Emergency Contact:
Home Phone:
Cell Phone:
Email:
Relationship to you:
SPRING BREAK VISION SITES
Please rate ALL SITES in order of preference (1= First choice, 6= Last choice). We
ask that you be open to any of our six sites. We do our best to place you on one of
your top choices.
Dacotah Tipi Habitat for Humanity: Crow Creek Reservation
BitterRoot Catholic Worker Farm: Missoula, Montana
La Puente Shelter: Alamosa, Colorado
Amate House: Chicago, Illinois
Bethlehem Farm: Pence Springs, West Virginia
___ White Earth Land Recovery Project:
VISION Spring Break 2016 Application
QUESTIONS
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How did you hear about VISION?
Have you been on previous VISION trips? Please list all:
How did you hear about VISION?
In 500 words or less please explain your reasoning behind choosing your top three
preferences.
5) How has your personal history led you to apply to this program? What is your
motivation for applying to the VISION program?
6) What strengths do you bring to the VISION program? Give some examples from other
groups or experiences you have been a part of.
7) Describe an experience in your life that has been especially powerful or formative.
What impact has it had on you and your life?
8) Having read the Six Components (attached to the application), what makes you excited
about participating in VISION?
9) Having read the Six Components, what makes you most uncertain about participating in
VISION?
10) Please list any personal health matters that would be pertinent to placing you on a trip
(i.e. allergies, motion sickness, medications, food concerns, asthma, diabetes, etc)
11) Is there anything else you would like the VISION program to know about?
VISION’S SIX COMPONANTS
Service is foundational to VISION trips. You will work alongside residents of the community
you visit to address human, social and environmental needs. Your service may be tangible:
building a home and seeing the finished product. Or your service may be intangible: tutoring a
child without knowing the impact of your work. Each trip will incorporate both types of
service.
Simplicity is a difficult component for many of us. We come to depend on conveniences or
luxuries and have many choices about how we spend our time. Your group will decide
together how to take with you only what you truly need. At your site, your choices may be
limited by geography, money, transportation and safety. These limitations challenge our habits
and help us examine the difference between needs and wants.
Spirituality is about your own faith, beliefs and convictions as well as the context for this
program. VISION is directed from the Department of Campus Ministry. It springs from the
Catholic tradition of social justice and the Gospel call to service. VISION welcomes anyone to
participate as long as you are open to exploring and sharing issues of faith. Nightly reflections
VISION Spring Break 2016 Application
offer the opportunity to share your own spirituality with others in the light of the
day's experience.
Community is developed within the VISION team and in cooperative work at your site. Your
team will create a group agreement, reflect together and grow as a community through shared
work. You will also establish connections with other volunteers and residents at your site
through work, play and learning experiences.
Cultural Exchange is a two-way street: sharing your culture with those you visit, and learning
about theirs, too. Depending on your site, you may be invited to an Appalachian Jamboree, a
Southern Gospel Church, a Native American pow-wow, or a local historical or cultural
institution. You will share your cultural identity through story, song or example.
Justice Issues are the broader concerns of your work. Beyond direct service (e.g. serving a
meal) you will learn about the causes of poverty, oppression, etc. and responses made to
address these issues. Through presentations and educational opportunities, you will discover
the political, economic, social, historical and religious issues behind your service work.
VISION APPLICANT AGREEMENT
BY SIGNING BELOW, I CERTIFY THAT I:
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Am an undergraduate student at the University of St. Thomas
Take full responsibility for meeting the financial responsibilities of the trip.
Do not currently have any financial holds on my account
Am 18 years of age or older
Have turned in a complete application including Passport copies and emergency contact
info.
Am in appropriate physical and mental health (and am willing to provide documentation
from a physician and or professional therapist if requested).
Am not currently on conduct probation with the University.
Am willing to participate fully in the trip and am committed to supporting
and living out the Six Components (Service, Spirituality, Simplicity, Justice
Issues, Community, and Cultural Exchange) during this trip. I understand
that this includes a willingness to:
o Serve as I am asked to.
o Participate in discussions and educational opportunities offered by the site and
group.
o Cope with a variety of challenging situations and circumstances that may come
with visiting another culture and/or another country.
o Live and serve in community with fellow group members and others at program
sites.
VISION Spring Break 2016 Application
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o Engage in nightly reflection and converse with group members about
topics such as spirituality and faith.
o Respect the given rules and structure of the program site.
o Listen and learn about social and economic injustices from the viewpoint of the
people from the area which we visit.
Will participate in at least three orientations, including the Large Group Orientation
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Agree to meet the specific expectations and responsibilities decided upon by my
particular group in our Group Agreement.
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Will not participate in any consumption of alcohol or use of drugs. Support of this policy
by all involved is essential for a safe and socially aware break.
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Will comply with St. Thomas’ rules, standards, and instructions for student behavior.
Your typed name is your signature:
Date: