5-11 January 2020
US/Central timezone
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Registration Form

Please, note that fields marked with * are mandatory


Important Message
 

Students who are committed to participating in this Raider Service Break will fill out the below application and continue with the application fee process. This fee is a non-refundable deposit going towards the cost of the trip and securing their spot. ONLY COMMITTED STUDENTS!

Refunds will only be given if RSB cannot accommodate you or trip is canceled.

If you have additional questions before committing, please schedule a meeting with Jacy Proctor


Personal Data
 
First Name: *
Last Name: *
R#: *
Phone Number: *
555-555-5555
Primary Email: *
*Please use your TTU email as your primary email.
Alternative Email: *
*Please provide an alternative email that is NOT your TTU email.
Which gender best describes you? *

Which of the following best describes your race/ethnicity? *

Survey Questions
 
T-Shirt Size: *

What is your current standing at TTU? *

In which college are you enrolled? *

Please explain why you have chosen to participate in this Raider Service Break and what you hope to gain from this experience.
*

I authorize and consent to the release of my records, which may include my GPA, major, enrollment status, and academic standing with the purpose of verifying elgibility for an alternative service break trip. *


Registration
 
Click if you are an International Student
If you are an International Student, please meet with your International Counselor in the Office of International Affairs to discuss your volunteer work and travel. You may need to get a letter that approves you to work "volunteer" within the U.S. and internationally.
*
I am committed to this trip and I understand the payment options and process.
*
Application Fee Deposit:  50.00 USD  [12 place(s) left]