Student Leadership Camp Application Form 22-25 September 2017
I understand that an important part of the student leadership camp is to gather information that will inform further program development. This information will include surveys, focus groups, and interviews. Upon acceptance to the camp, you will receive full details. In the interim, if you would like to know more about the kind of information you will be asked to provide, please contact Aletta at otofficefin@uitweb.co.za
Last Name *
Your answer
First Name *
Your answer
Gender: *
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Age: *
Your answer
Date of birth: *
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Race: *
Your answer
ID or Passport Number: *
Your answer
University: *
Your answer
Year of study: *
Your answer
Are you a student member of OTASA? *
Home address:
Your answer
City:
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Province:
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Postal Code:
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Telephone:
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Cell: *
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Email: *
Your answer
Please list any accommodations needed:
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Emergency contact*: *
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Relationship: *
Your answer
Phone: *
Your answer
Why do you want to attend the OT Student Leadership Camp? Write a 250 word motivation. *
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Signature of Applicant: *
Your answer
Date signed on: *
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