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.
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Email Address *
First Name/Line Name/Last Name *
Chapter/Colony Affiliation *
Status *
Cell Phone Number *
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? *
Why are you interested in participating in the Cambianda Vidas home build? *
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? *
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)
Are you able to pay the $150 deposit by October 31, 2017? *
This deposit will go toward covering the total cost of the trip.
Do you have a valid passport? *
If selected, which airport would you fly out of? *
(Include airport code, city, state)
What is your role in creating social change? *
If selected to be an alternative break trip team member, how will you balance your commitment as a member with your other activities? *
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