Fillable Asb Application Fillable (Bowie State University)

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Asb Application Fillable (Bowie State University)

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Bowie State University
Alternative Spring Break 2019
Service Trip to Charleston, SC
This year’s Alternative Spring break trip is focused on serving the residents of Charleston,
South Carolina. Service may include working at local community organizations such as
churches, food banks and schools. Students will also have the opportunity to participate in
cultural/educational events during evenings. This trip is scheduled for March 18–22, 2019.
The application process is required due to the limited number of spots available for this trip.
Cost to BSU Student: $100
Program fees include the following:
Transportation
Lodging accommodations
Admission for tours
Required documents:
Participant Agreement
Financial Obligation Form
Application deadline:
Friday, March 8, 2019 by 12 a.m. via email
ASB Charleston, SC Participant Agreement
Name: ______________________________________________ Student ID: _______________________
Address: _____________________________________________________________________________
Phone: ________________________________ Alternate Phone: _______________________________
Email: _______________________________________________________________________________
Age: ______ Date of Birth: ____________Gender: _____________________________
Academic Classification(circle one):
Freshman Sophomore
Junior Senior
Graduate Student
GPA: _________ Major(s)/ Degree Program: _____________________________________
Emergency Contact:
Name: __________________________________Phone: _________________ Relationship: _________
Dietary Needs: ________________________________________________________________________
Allergies
food/medicine/etc:___________________________________________________________________
If selected to participate in ASB Charleston, SC 2019, I will attend ALL participant meetings (1-2 before
trip) as described in the program details information.
By turning in this form, with the signed financial obligation form you are committing fully to the
program including but not limited to financial and participatory requirements. Student participants
are expected to be in good academic standing with the university. Trip attendance is not guaranteed
until these checks have been completed.
By signing this form, I agree to participate in nightly meetings and journaling during the ASB trip.
Signature: _____________________________________________________Date: __________________
Please submit to vpsa@bowiestate.edu and jcarpenter@bowiestate.edu.
For more information, contact Janay Carpenter by email or phone: 301-860-3289
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ASB Charleston, SC Application
Please attached additional sheet, if needed.
1. What does it mean to serve?
______________________________________________________________________________
______________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
______________________________________________________________________________
2. How do you hope to benefit from this trip?
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________________________________
3. What activities or co-curricular things have you been involved with while at BSU
(freshman may include activities from their senior year; please specify if activity is from
high school)?
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
4. What service have you performed while at BSU (freshman may include service from
their senior year; please specify if service is from high school)?
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Financial and Travel Obligation
Form
Alternative Spring Break 2019
Listed below is an outline of the financial and travel obligations related to the Alternative Spring Break (ASB) Program in Charleston, SC.
Total Program Fee: $500 per participant
Cost to BSU Student: $100
*The Student Affairs office will cover the remaining cost per student.
Payment:
✓ 100% of the money is due by March 11, 2019 by 4 p.m. in the Student Affairs Office
(2
nd
floor of Henry Administration)
✓ Payment can be accepted in the form of cash.
✓ Full $100 MUST be paid in full to be eligible to go on the trip.
ASB Program Fees include the following:
✓ Transportation
✓ Lodging accommodations
✓ Admission for tours
Statement of Agreement:
I have read and understand the financial obligations of the ASB program. I acknowledge my
responsibility to seek out sponsorship if I cannot afford to pay for the trip myself. I have read and
understand the ASB Financial Obligation Form, Participant Agreement, and the Business Agreement
and accept all rights, responsibilities, and obligations that are affiliated with Bowie State University’s
ASB. I authorize ASB staff to verify enrollment, financial payments and discipline records.
Name (Printed): _____________________________________ Student ID: ________________________
Signature: ____________________________________________ Date: __________________________
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Completed 21 July 2020

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