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2012 GSI Application

Applications for the 2012 Global Service Initiative trips are now being accepted. Please note the timelines below. Upon notification of acceptance in to the program, participants must make an initial non-refundable deposit. Participants are responsible for their own travel expenses and arrangements, as well as securing a passport (if needed). For more information, please contact Michelle Rebholz, Director of Educational Programs, at marchand@deltau.org.

GSI Spring Break - New Orleans, Louisiana
March 18 - 24, 2012
Cost to participate: $500 + travel expenses
Application deadline: February 1, 2012
Notification of selection: February 6, 2012
Deposit: $250 due February 17, 2012
Final payment: $250 due March 9, 2012

GSI - Negril, Jamaica
May 12 - 19, 2012 and June 2 - 9, 2012
Cost to participate: $1,000 + travel expenses
Application deadline: March 1, 2012
Notification of selection: March 15, 2012
Deposit: $500 due March 30, 2012
Final payment: $500 due April 30, 2012

If you are registering as part of your chapter's Global Service fundraising efforts, please check the appropriate box below.

First Name *
Last Name *
Chapter
Cell Phone Number *
Email Address *
Campus Address
City *
State/Province *
Postal/Zip Code*
Major*
Minor
Grade Point Average (GPA)*
Special/Dietary Needs
I'm applying to participate in the following trip(s): Rank in order of preference (3 drop down menus with each of the options below listed "First Preference", "Second Preference", "Third Preference") *
GSI Spring Break New Orleans (March 18 - 24, 2012)*
GSI Jamaica (May 12 - 19, 2012)*
GSI Jamaica (June 2 - 9, 2012)*
My chapter/colony has reached a Fundraising Level and I'm applying as our participant.
Why are you interested in participating in the Global Service Initiative? *
What do you expect to gain from participating in this experience? *
We are looking for a group of members that is both effective and diverse. Please comment on the strengths you would bring to this group (related experience, leadership, interpersonal skills, etc.) and on the qualities and experience you could contribute to the diversity and character of the group. *
Photo/Media Release: You grant Delta Upsilon permission to use your name and any photographs, audio, and/or video of and/or quotes from you, without compensation, in any promotional materials and publications in connection to Delta Upsilon.*	I agree
Drug Free Policy: The Global Service Initiative promotes a drug free philosophy. This prohibits illegal drug use by anyone during the Global Service Initiative. Any member who does not adhere to this policy will be asked to leave the initiative and return to his place of residence at his own expense.*	I agree
Participation: You will participate in all pre-initiative webinars/activities. You also agree to participate in any and all group activities during the trip. Dates for all activities will be communicated through email.*	I agree
Physical Requirements/Insurance: The Global Service Initiative can be extremely physically demanding and may take place in extreme temperatures. You understand that you must be in good physical condition, with health insurance, to fully participate in the initiative. You will be asked at a later date to furnish documentation of health insurance. *	I agree
Refunds: You are aware that all payments made to the Global Service Initiative are non-refundable.*	I agree
Feel free to upload any supporting documents to be included in your application.
By typing your name below, you understand and agree to the expectations set forth in this application, and are aware that a failure to meet these expectations may results in your exclusion from this program. *

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