> Loyola Marymount University > Student Life > Student Affairs Division > Activities & Service > Center for Service and Action > Service Opportunities > Alternative Breaks Program > Apply to Alternative Breaks > Haiti Supplemental Application
 

Haiti Supplemental Application


Warning: This form will time out.  Please read the essay questions and write your answers in a word processing document.  When you are done answering all of the questions, copy and paste your answers into this form. If this form is submitted correctly, you will be directed to information about interviews for Haiti.

Before filling out this application, please take the time to read about this trip HERE.

Page 1 of 1
Required
Required
Required
 
Required
 
Required
Class
Required
Which Haiti trip(s) are you interested in attending?
 
Have you ever travelled internationally?
Required
 
SHORT ESSAY QUESTION In the space provided, please respond to the following questions:
Required
Required
Required
Please rate your experience with construction
Required
Please rate your experience with camping
Required
Please rate your experience with painting
Required
Please rate your experience with teaching
Required
The conditions in Haiti are difficult and always changing. It will be hot, the physical labor will be tough, and you will be challenged. At times, there will only be one option for food, and exceptions will not be made. Your signature below indicates that you are aware of these challenges and will not complain on the trip. If you believe this will be a problem for you, please explain in the space provided below.
Required
Pick date
Clear selection