Proudly Announces:
2015 Winter Break Service Trips Participant Application
The definitive service experience for students on Wartburg’s campus.
Winter Break
Applications are due to or to Box 625 (c/o Jamie Harrings) by Noon on November 13th.
Wartburg College Service Trips are dedicated to providing opportunities thatactively engage participants with communities through service, reflection andlearning. Our vision is to inspire participants to create social change by leading livesof continual learning and service.
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Registration & Fees:
Registration includes everything participants will need for the week:
•On-site meals
•Housing & transportation
•$20 for meals en route
•An Experience You Won’t Soon Forget!
Application Deadline / AmountNovember 13, 2014 @ Noon / $175*
*A non-refundable $50 will be charged to your Student Account on December 1, 2014. The remaining balance will be charged to your account on February 1, 2015.
Under special circumstances, such as financial hardships, there may be support from the service trip endowment fund. For more details on how to apply for this, contact Service Trips at by the application deadline. The rest of the fee will not be charged if the participant is not accepted or withdraws (in writing, email is accepted) prior to the application deadline or announcement of trips. Participants who withdraw within two weeks after trips have been set may receive a refund equal to 1/3 of the full fee. Participants who drop after the two week time frame will not receive a refund unless the reason includes illness or injury that prevents the participant from traveling or a documented family emergency.
Housing & Meals:
All housing and meals during the Service Trip are provided. Participants are required to stay with their groups in the accommodations and to actively participate in all activities throughout the week.
Service Trip Policies:
WST participants are required to follow ALL Wartburg policies before, during, and after the trip and are responsible for any outstanding funds after fundraising. (For a full review of the policies, please visit,
Meetings, Trainings, & Trip Activities:
Being a WST participant requires time, energy, and commitment. I understand I’m making a commitment to attend ALL MANDATORY WST events, including (but not limited to) all fundraising activities, pre- or post-service activities, pre- trip meetings and trainings as well as reflection activities before, during and after the trip. Failure to fully participate in the above activities could result in removal from the trip.
Fundraising:
In addition to the participant fees, service trips receive financial support from both Student Senate and the Center for Community Engagement. However, this financial support typically is not enough to cover all costs. As a service trip participant you will work with your trip leaders to strategize additional funding options for transportation, food and lodging. All service trip participants will be required to send donation request letters and be required to participate in the fundraising efforts of their trip.
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Wartburg College Service Trips 2013-2014
Registration Form:
Which trip do you wish to go on?
(Please rank ALL trips in order of preference [i.e. 1 is the one you would like to go on the most].
Winter Break Trips:
__ “Messy Mississippi River Clean Up”
__TBD Trip led by April Magneson and Sabrina Sieg
__”Flood Relief in Colorado”
__”Pulling East St. Louis Out of Poverty”
__”Break A Difference”
__”Students UKnight for Service”
__”Caring for Kids in East St. Louis, IL”
Is there someone you would feel more comfortable if they were on the same trip? If yes, who? ______
*Please note this DOES NOT guarantee you will be on the same trip, nor does it increase the likelihood of getting your first choice in trip.
General Information Please type clearly. Information will be sent via e-mail so it is important to provide an e-mail address you check periodically.
Name ______E-Mail ______
Year in School Phone Number ______Age at Time of Trip _____ T-Shirt Size: __ S __ M __ L __ XL __ XXL
Emergency Information Please type clearly.
In case of emergency, contact:
Name ______Relation ______
Phone Number ______
Secondary Phone Number ______
Medical Insurance Information
Company ______Plan______
Account/Policy # ______Expiration Date ______
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Free Response Questions
Please respond to each of the following questions individually or incorporate your answers into one concise personal statement. Responses should be no longer than 1 page combined and attached to this application.
1. What draws you to your top issue? 2. Why are you interested in participating on a Service Trip?
Drug & Alcohol Free Agreement:
Wartburg recognizes that drug use and alcohol abuse are a contradiction to its understanding of community, and that use of illegal drugs and alcohol abuse may impair work performance and judgment, endanger colleagues, and cause physical damage. Therefore, it is the policy of Wartburg College Service Trips that all participants (which includes leaders and advisors) will be drug and alcohol-free during the Service Trip experience. If a participant is found to be using, possessing, manufacturing, or distributing controlled substances or alcohol, or knows of someone who is, they will be required to return home at their own expense. Participants found in violation will not be permitted to participate in Service Trips for at least one year.
Acceptance of Full Participation Agreement
I have read the Service Trips cancellation policy and agree to its terms. I also understand that the Service Trips are completely alcohol and other drug free. If I am found to consume these substances anytime during the official Service Trip, I will be asked to leave without reimbursement. Furthermore, I understand that I am part of an Service Trip experience that requires me to remain on location with the group for the entire week. Finally, I understand that at least 6-8 hours of direct service projects in the local community will be performed daily. I affirm that I am willing and able to participate in these projects, some of which may require physical labor. I agree to notify Service Trips immediately if I have an illness or disability that will prevent me from engaging in strenuous physical activity or certain types of projects (alternate projects can be arranged in these circumstances). I also understand that I will be expected to participate in all scheduled activities, including pre-trip meetings, service projects, reflection sessions, and other activities.
By giving my Student ID #, I affirm that I have read all of the policies listed on this application including, but not limited to, the registration and fees, fundraising, meetings, and drug and alcohol free.
Student ID # ______Date ______
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