student-life-4

Application Form for Students Who Want to Go on Service Trips

BEFORE you begin filling-out this application form, have the following information with you: (1) Name, Title & Contact Info of a Madison College Faculty/Staff Member as your Reference (2) List of Agencies where you have volunteered.

Information requested on this form is utilized to verify enrollment, prepare travel approval request forms, driver authorization applications, airline manifest requirements, participant lodging reservations, volunteer-group service-organization agreements & assignments, waiver & release of liability forms, emergency contact information, travel conduct agreements, etc.  Information on this form is accessed by Professional Staff Members from the Student Life Center, by the student who is the  Alternative Break Coordinator from the Volunteer Center Board of Directors, by Faculty/Staff Members selected to be Service Team Advisors & by students selected to be Service Team Leaders.   

Allow 20 - 30 minutes to complete this application form. Once started, it cannot be saved & returned to for completion at a later date. This form is completed when you hit "submit" at the end of the application.

Service Trips are not open to students under the age of 18. Likewise, it is a college policy that persons under the age of 25 are not allowed to drive rental vehicles.

Alternative Spring Break Service Trips

Sunday March 16-Saturday March 22, 2014

The International Wolf Sanctuary and Vince Shute Wildlife Sanctuary in Ely & Orr, MN 

Exact departure / return times to-be-determined

The Service Team will consist of 10 students, a Student Trip Leader & a Faculty or Staff Advisor. Teams will drive to their destination & will share a rental home.  Transportation, lodging & most meals are included.

The goal is for each student team member is to provide 30-40 hours of service work on location. The trip costs $250.00 per student.  All checks should be made out to Madison College and are accepted in the Student Life Office at Truax room C1420.  The $100 deposit is due at the time of application [non-refundable, if selected for a team]; final $125.00 due February 21, 2014.  There are scholarships available however students must apply to be considered for a scholarship.

The Gleaners Food Bank & Second Helpings Food Pantry in Indianapolis, IN trip. 

This Service Team will consist of 10 students, a Student Trip Leader & a Faculty or Staff Advisor. The team will drive to their destination & will share a rental home.  Transportation & most meals are included in the cost $200.

The goal is for each student team member is to provide 30 - 40 hours of service work on location. The trip costs $200.00 per student.  All checks should be made out to Madison College and are accepted in the Student Life Office at Truax room C1420.  The $100 deposit is due at the time of application [non-refundable, if selected for a team]; final $100.00 due February 21, 2014.  There are scholarships available however students must apply to be considered for a scholarship.

 

St. Bernard Project Rebuilding the Homes & Lives of Katrina Survivors New Orleans, LA

Trip will depart on March 16 from the General Mitchell International Airport (MKE) in Milwaukee, WI.

The Service Team will consist of 10 students, a Student Trip Leader & a Faculty or Staff Advisor. Teams will fly to their destination & will stay in at St. Jude Community Center.  Flight, lodging, ground transportation & most meals are included.  Students will need to bring sheets, towels and bed coverings.  Travelers are able to check two bags and the cost is already included in the expenses.

The goal is for each student team member is to provide 30-40 hours of service work on location. The trip costs $400.00 per student.  All checks should be made out to Madison College and are accepted in the Student Life Office at Truax room C1420.  The $100 deposit is due at the time of application [non-refundable, if selected for a team]; final $300.00 due February 21, 2014.  There are scholarships available however students must apply to be considered for a scholarship.

Women of Color Scholars Program in Benton Harbor, MI

This Service Team will consist of 10 students, a Student Trip Leader & a Faculty or Staff Advisor. The team will drive to their destination & will share a rental home.  Transportation & most meals are included in the cost $250.

The goal for each student team member is to provide 30-40 hours of service work on location. The trip costs $250.00 per student.  All checks should be made out to Madison College and are accepted in the Student Life Office at Truax room C1420.  The $100 deposit is due at the time of application [non-refundable, if selected for a team]; final $150.00 due February 21, 2014.  There are scholarships available however students must apply to be considered for a scholarship.

First ChoiceSecond ChoiceThird ChoiceFourth ChoiceNot Interested in This Trip
International Wolf Sanctuary & Vince Shute Wildlife Sanctuary Ely & Orr, MN
Gleaners Food Bank and Second Helpings Food Pantry in Indianapolis, IN
St. Bernard Project in New Orleans, LA
Women of Color Scholars Benton Harbor, MI
Please be aware that due to service-team size limitations, team balance, etc., you may not be selected for your most desired choice.

SHORT ANSWER QUESTIONS: Your responses to the following questions will assist in determining your eligibility for participation in a Service Trip. Information will also be utilized to determine if you will be invited for an interview.

If none, please indicate so.
If none, please indicate so.
If none, please indicate so.
If none, please indicate so.
This section is included to assist the student in realistically assessing his or her ability to financially support his or her Service Trip experience. Students who are short on funds are encouraged to contact the Volunteer Center at http://madisoncollege.edu/volunteer-center & inquire about "fund-raising tips" & / or become engaged in local community service projects that are free or low-cost. Students selected for a Service Team, who do not pay the remaining balance by the due date will NOT be allowed to travel & will forfeit their $100.00 deposit.
By entering my first & last name in the field above, I certify that the information I have supplied on this application is complete & accurate to the best of my knowledge. I understand that knowingly submitting inaccurate or false information may result in my not being selected for a Service Team.

Thank you for your interest in the Alternative Break Service Trip Program. Applications are carefully reviewed at the time of submission & applicants may, or may not, be invited for an interview. Service Team members are selected based on information collected in the application, possible course participation & in the interview process. Please understand that when Service Teams are full, they are FULL. Applicants not selected for a team, will have their applications kept on-file, in the event that there is a last-minute cancellation by a team member.