Ecothropic Study Abroad Statement of Intention
Email address *
Which program are you applying for? *
Full Name *
Your answer
Email Address *
Your answer
Permanent Mailing Address *
Your answer
Current Address (if different than your permanent address) *
Your answer
Do you have a current passport that will not expire until 6 months after the program ends? *
Passport Issuing Country
Your answer
Passport Number *
Your answer
Passport Expiration Date *
MM
/
DD
/
YYYY
Do you hold a passport from any country other than the U.S.A.? Which? *
Your answer
Are you Cuban-American, whether or not it states this on your passport (for Cuba applicants) *
Will you be enrolled in a university at the time of the course? *
Which university will you be enrolled in? *
Your answer
Credit Option *
Parent/Guardian Name *
Your answer
Parent/Guardian Phone Number *
Your answer
Parent/Guardian Email *
Your answer
Parent/Guardian Mailing Address *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone Number *
Your answer
Emergency Contact Email *
Your answer
Reference #1 Name *
Your answer
Reference #1 Email *
Your answer
Reference #1 Phone *
Your answer
What's your relationship with Reference #1? *
Your answer
Reference #2 Name *
Your answer
Reference #2 Email *
Your answer
Reference #2 Phone *
Your answer
What's your relationship with Reference #2? *
Your answer
How did you hear about Ecothropic Field Studies *
Required
If it was a person that referred you, please tell us who it was
Your answer
Please check all that apply *
Required
Please give the details for any of the boxes that you checked above (if none apply, please type that here). *
Your answer
Do you have or have you ever had any of the following? *
Required
Why are you interested in joining us? *
Your answer
Why are you interested in going on this program in particular? *
Your answer
What do you hope to gain from your experience on this field study? *
Your answer
Detail the kinds of community/group experiences you have had. Why do you want to do a group-oriented program now? *
Your answer
Why are you interested in ecology, agriculture, and climate change? *
Your answer
What courses have you taken or what experience do you have that relates to ecology, agriculture, sustainability, climate change, watersheds, food-systems, or anything else you think might apply? *
Your answer
How do you think your participation will benefit the group? *
Your answer
What single event or experience of your life had the most impact on you? Why? *
Your answer
Which part of the itinerary are you most excited about? *
Your answer
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