Spring 23 Social Action Trip Application
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First Name
Last Name
E-mail
Phone Number
Year in School
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What College/School are you in?
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Please rank your trip selection. 
US-Mexico Border Immigration Focus (Thursday, 4-6pm)
New Orleans LGBTQIA+ Focus (Tuesdays, 5-7pm)
Belize Multiculturalism Focus (Mondays, 5-7pm)
No interest in others/Time conflicts for others
1st Choice
2nd Choice
3rd Choice
Clear selection
If you are interested in the Civil Rights Pilgrimage, please apply at the link below.  You do not need to apply on this form. 
https://docs.google.com/forms/d/e/1FAIpQLSfnYzosvrts4ZJyqlF3pRj4Qma_Kftku3gMqU__vWzEwbubPw/viewform
Why are you interested in this experience?
What do you hope to gain from the program?  
Please note, to participate on the trip, you have to be able to make all of the meetings before and after the trip as well as the entire trip. The meeting times are listed above with group selections.
Clear selection
Will you need a scholarship to assist with a portion of the cost? 
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Please list any allergies we should be aware of when traveling and planning group meals.
Dietary Requests/Needs
Emergency Contact name
Emergency contact phone and e-mail.
I understand if I am selected for Belize or the Border trip I will need a passport.
Clear selection
Are you able to attend ALL meetings for the trips in your selection list prior to departing and upon coming back to campus?

They are:
US-Mexico Border (immigration focus)- Thursdays 4-6pm
New Orleans (LGBTQIA+ focus)-Tuesdays 5-7pm
Belize (multicultural focus)- Mondays 5-7pm
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Is there anything else you would like us to know? 
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