Shirts Across America · 2018-19 Student Volunteer Trip Application- Eastside Catholic School Copy

Student Applicant Information

Name

*

First Name

Last Name

Preferred Name

The name your teachers call you.

Sex

*

This is what is indicated on your identification or passport.

Mobile Phone

*

or best phone number to reach you.

Email

*

Please choose an email that you check regularly.

Verify Email

*

Address

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

High School

*

Year in school (for the 2018-2019 school year)

*

Graduation Year

*

Have you ever attended any other high school?

*

Yes

No

Please list the name(s) of previously attended high school(s).

Date of Birth - Example: 08/29/1992. Please be sure your correct YEAR of birth displays.

*

(mm/dd/yyyy)

What age will you be on the start date of your preferred trip?

*

Mid-Winter Break Trip Start Date: 02/16 Summer Break Trip Start Date: 06/23

T-Shirt Size

*

Race or Ethnic Identity

*

Please check all that apply.

American Indian or Alaskan Native

Asian

Black or African American

Hispanic or Latino

Native Hawaiian or Pacific Islander

White (not Hispanic or Latino)

I do not wish to Self-Identify

Parent/Guardian #1 Contact Information

Parent/Guardian #1

*

Prefix

First Name

Last Name

Suffix

Mobile Phone

*

Home/Work Phone

Email

*

Verify Email

*

Address

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Parent/Guardian #2 Contact Information

Parent/Guardian #2

Prefix

First Name

Last Name

Suffix

Mobile Phone

Home/Work Phone

Email

Verify Email

Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Trip Information

School and Trip Schedules

Mid-Winter Break (February 16 - 23, 2019): Eastside Catholic School, Los Gatos Chapter & Roosevelt High School

Summer Break (June 23- 30, 2019): St. Joe's, NLYM & students from all SAA partner schools may apply

First preference for volunteer trip?

*

Please select week of your school break OR Summer Trip.

Second preference for volunteer trip?

*

Please select week of your school break OR Summer Trip.

Do you need a partial scholarship to help fund your trip?

*

Yes, I am requesting a need based partial scholarship.

No

Dollar amount you are requesting:

Do you receive Financial Aid or Free and Reduced Price Meals from your school/school district?

*

Please explain why you are requesting a partial scholarship.

Short Paragraph Responses

IMPORTANT: We highly recommend you type your responses into word/text document and save to your computer. Please paste your answers into the respective field below. Your saved document may come in handy should any technical difficulties occur when you submit your application.

Why do you want to volunteer with SAA? What do you hope to learn from participating in one of our immersion trips?

*

Hurricane Katrina hit New Orleans 13 years ago. What do you know about recovery efforts in New Orleans? Why do you think it is important to continue rebuilding efforts?

*

What does "home" mean to you? Why do you want to help others move home?

*

Have you had an opportunity to volunteer in your local community this past year? Tell us about your experience(s).

*

What is a unique quality you bring to a team/group environment? Please explain.

*

Who in your life has influenced you the most? Please explain why.

*

Is this your first trip with Shirts Across America?

*

What year(s) did you volunteer with SAA?

2018

2017

2016

2015

How Did You Hear About SAA?

*

Please check all that apply:

I have a sibling who volunteered with SAA

I have a parent who volunteered with SAA

I have another family member who volunteered with SAA

I have a friend who volunteered with SAA

Through Social Media (Facebook, Instagram, Twitter)

Through SAA's website

Other

Disciplinary History

Have you ever been found responsible for a disciplinary violation at any academic institution, related to behavioral misconduct, that resulted in your probation, suspension or expulsion?

*

By answering yes, you are not automatically disqualified from participating in a Shirts Across America trip.

Yes

No

Please explain.

If you would prefer to have a conversation over the phone about this, please email RNovak@shirtsacrossamerica.org to set up a phone call.

Have you ever been expelled or asked to leave an academic institution(s)? If so, please name the academic institution(s) and the city and state the institution is located in.

2019 NOLA Trip Application

Eastside Catholic School Student Volunteers

Thank you for your interest in applying to our program!