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.
Email Address *
Your answer
First Name/Line Name/Last Name *
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
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