ECSS 2017 – Participant Application
East Coast Solidarity Summer (ECSS)

WHO: 15-24* year olds of South Asian and Desi heritage living in the east coast (ie. Northeast & DMV areas)
WHEN: July 12-16, 2017
WHERE: Murray Grove Recreation Center, Lanoka Harbor, NJ

Have fun with this application!
We want to get a sense of who you are and what you want to gain from this experience.
There are no "right" answers -- just be honest!

Questions?
Feel free to e-mail us at eastcoastsolidaritysummer@gmail.com or visit us at eastcoastsolidaritysummer.weebly.com

*Our age range is flexible and applicants below/above the range may still apply & will be considered on a case-by-case basis!

Your Name
(First Last)
Your answer
What are your pronouns?
(e.g. she/her, he/him, they/their, ze/zir, etc.)
Your answer
Full Home Address
Address, Apt # / City State Zip
Your answer
Phone
Primary phone number
Your answer
E-mail
Your answer
Your Date of Birth
Your answer
Your specific South Asian heritage?
Afghan, Bangladeshi, Indian, Indo-Caribbean, Guyanese, Nepali, Trinidadian, Pakistani, Sri Lankan, etc. (as well as your other ethnic/racial/caste heritages)
Your answer
Do you have any allergies? If so, please specify.
(e.g., foods, certain pets, chemical solvents, scents, etc.)
Your answer
Do you have any dietary restrictions? If so, please specify in detail.
(e.g., vegetarian, halal, vegan)
Your answer
Do you have any prayer needs during the event? If so, please specify.
Your answer
Do you have any accessibility needs? (e.g., wheelchair-accessible, scent free, etc.) If so, please describe them.
Your answer
Are you comfortable using gender neutral housing and restrooms?
Gender neutral room assignments would be made at random, regardless of your gender. If you would prefer to room with someone of your same gender, please indicate that below. All restrooms will remain unassigned by gender.
Are you a student? Please specify.
(ie. educational institution, level in high school/college, field of study)
Your answer
Have you engaged with ECSS (formerly known as DC Solidarity Summer) in the past?
If you have applied to the program or attended in the past, please explain why you are choosing to re-apply. We prioritize new attendees and will evaluate returning participants on a case-by-case basis.
Your answer
Please describe any talents or skills you might like to share at East Coast Solidarity Summer.
The last night of our retreat includes a talent show!
Your answer
How did you hear about East Coast Solidarity Summer?
Your answer
Short Essay Questions
Please answer the questions below in 5 sentences *or fewer.* Again -- we're just looking to learn more about you as a person so please be honest and don't stress out!
Why do you want to participate in East Coast Solidarity Summer?
Your answer
What kinds of South Asian spaces do you have access to (if any)? What are those spaces like for you?
Your answer
Which issues are you passionate about? What are some of the biggest challenges you see in your South Asian community?
Your answer
What do you want to take back with you as a result of participating in East Coast Solidarity Summer?
Your answer
Please submit your workshop suggestions here:
In the past, we have included workshops on casteism, racism, immigration, queer/transgender liberation, environmental justice, sexism, body image, sizeism, colonialism, imperialism, etc. What other kinds of workshops would you like to see at ECSS 2017?
Your answer
If selected to participate in ECSS 2017, I will be fully committed to the event, which means I will participate actively, arrive on time, and help create a positive sense of community.
July 12-16, Murray Grove Retreat Center, Lanoka Harbor, NJ
Are you able to contribute a suggested donation of $1-50?
ECSS is an entirely grassroots project, supported by individual donors outside of the nonprofit-industrial complex. If you have access to wealth, we would like to emphasize that ECSS depends heavily on these contributions to complete our year-long fund-raising project! You are also welcome to donate more than the suggested amount.
Required
Are there any other barriers to your attendance that you'd like to share with us at this time?
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms