Gamma Phi Omega's Alternative Break Trip Application
Please complete the form by September 15, 2017. Applicant's will be notified by September 30, 2017, if they are selected to participate.
First Name/Line Name/Last Name
Your answer
Email Address
Your answer
Chapter/Colony Affiliation
Your answer
Status
Cell Phone Number
Your answer
Are you fluent in Spanish?
You do not need to be fluent in Spanish to attend the trip.
Not Fluent at All
Fully Fluent
In the past, have you participated in an alternative break trip?
Required
Why are you interested in participating in the Cambianda Vidas home build?
Your answer
Are you willing and able to work in high temperatures?
(July in the Dominican Republic ranges anywhere from mid 70's to low 90s)
Are you willing and able to lift and move materials associated with building a home?
Required
Are you willing to fundraise for the trip and/or otherwise be responsible for the total cost of attending the trip?
($1,200.00 plus airfare ranging from $600-$800)
Required
Are you able to pay the $150 deposit by October 31, 2017?
This deposit will go toward covering the total cost of the trip.
Required
Do you have a valid passport?
Required
If selected, which airport would you fly out of?
(Include airport code, city, state)
Your answer
What is your role in creating social change?
Your answer
If selected to be an alternative break trip team member, how will you balance your commitment as a member with your other activities?
Your answer
Are you interested in being a team leader?
Responsibilities would include, but are not limited to: • Coordinate and lead in-person meetings and/or conference calls on a monthly basis• Provide regular updates to the Director of Philanthropy • Collect all monies, update payment tracker, and submit payments to Cambiando Vidas• Ensure that all team members are fulfilling their responsibilities• Provide education on the traditions, culture, social context and expectations of the Dominican Republic and service trip• Lead group fundraising events• Lead nightly reflection sessions during trip• Coordinate flight arrangements and create itineraries, as necessary
What makes you uniquely qualified to serve as a team leader?
Your answer
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