Memphis Immersion

Saturday, March12 – Saturday, March19, 2016

Participant Application

Thank you for your interest inthe Gephardt Institute’sSpring Break Memphis Immersion. This experience will be an intensiveeight-day immersion into Memphis, Tennesseethatwill explore the historical and current social issues related to civil rights, diversity and inclusion in the city and beyond. Participants will engage with community members to understand how diversity and social justice impact all facets of life, including education, community, music and arts, and social services. We are seeking applicants who demonstrate an excitement to engage in these issues, a willingness to be uncomfortable or wrong, openness to share oneself and learn about others, and a commitment to grow and be changed. Please complete this application thoroughly and thoughtfully. If you have any questions, please contact Tim Dugan, Coordinator for Student Engagement and Service, at or 314.935.3943.

Applications are due Friday, January 29,before5:00pm.

Application Checklist

Complete the Memphis ImmersionParticipant Application

You must include all information in order to be considered. Be sure to complete both sides of each page.

Read and sign the Participant Commitment

Answer the Application questions

200 words maximum per question.

Provide the name of onereference who knows you well and can speak to your character

References can come fromadvisors, professors, WU staff, RCDs, mentors, RAs, or WUSAs.

Mark your calendar for the key dates noted on the next page

Key Dates

Application Deadline / Friday, January29, 5:00pm
Email to
[Sign up for a 20-minute interview]
Individual Interviews / February1-5
Selection / Monday, February8
All applicantswill be notified via email, regardless of selection
Acceptance and completion of Participant Forms online / Thursday,February11
Complete online by 11pm. Access forms at
Please email with any questions on the forms
Four pre-trip Trainings during spring semester / All trainings are 90 minutes, from 5:30-7:00pm
Tuesdays, February 16, February 23,March 1, and March 7
Additionally, participants may be given correlating short readings, assignments, and reflections, totaling about 30 minutes per week
Memphis Immersion / Depart Saturday, March12. Anticipated departure time is 8:00am
Return to campus Saturday, March 19. Anticipated return time is 4:00pm
This is a full-time commitment from morning to late evening,
with no opportunity for studying or personal socializing.
Two Post-trip Trainings / Alltrainings will be 90 minutes, from 5:30-7:00pm.
Tuesdays, March 29, and April 19
Additionally, participants may be given correlating short readings, assignments, and reflections, totaling about 30 minutes per week
One Reunion Training / Trainingwill be 90 minutes, from 5:30-7:00pm.
Tuesday, October 11

Memphis Immersion Participant Application

Full Name:______Student ID:______

Email:ell Phone:______

Sex:______Academic year:______GPA:______

(2.5 minimum. 3.0 preferred)

Primary school:______

Major(s):______

Dietary restrictions: ______

Name of one WU reference who can speak to your qualifications for participating in Urban Immersion (preferably faculty/staff, but RA & WUSA names will be accepted):

______

Reminder: If you are accepted, youmust complete the Service Trip Participant form by visiting gephardtinstitute.wustl.edu/trips. This formwill ask for insurance, emergency contact, and additional information.You will not be officially enrolled in Memphis Immersion until this formis complete, and your slot may be given to someone on the wait list if you miss the deadline.

Safety and Health

Memphis Immersion will involve elements of physical labor and bodily strain, including extensive walking and standing, climbing stairs, lifting and carrying heavy items, and conducting labor-intensive work such as painting andshoveling. Please provide information about medical or health needs that might preclude you from any of these activities so that all feasible accommodations may be made. If you prefer, you may contact Tim Dugan to provide him this information directly (see page 1 for his contact information).

______

______

______

Memphis Immersion Participant Commitment

Trip Commitment:

Being an effective service trip participant requires time, energy, and commitment. Participants are expected to participate in all aspects of the Spring Break service trip – including seven90-minute trainingsand reflection assignments. In order to be successful, participants must actively engage their peers, leader, hosts, and community partners. Trip commitment includes participation in service, reflection, education, and interaction; willingness to learn about Memphis, oneself, and others; and openness to new perspectives toward service and community engagement.

Drug and Alcohol Free Commitment:

Memphis Immersion is an alcohol and drug free program. Being drug and alcohol free allows participants to focus on learning through cultural immersion, relationships, and thoughtful reflections and discussions. This is also required for the safety and well-being of participants and the communities in which they will serve. Violation of this policy will result in immediate termination from the program. Violators will be expected to make a formal apology to the program’s community partners and will not be considered for future immersion experiences conducted by the Gephardt Institute.

By signing below I have read and agree to the Trip, and Drug and Alcohol Free commitments. I understand that failure to uphold these commits may result in my removal from Spring Break Memphis Immersion.

Signature: ______Date: ______

Fee

The MemphisImmersion participantfee is $250.

  • This feeincludes housing, meals, snacks, transportation, training/reflection materials, and fees/contributions to our partners for classes and presenters.
  • Fees will be directly charged to participants through their student account.

Civic Engagement Fund: Individual Need-based Grant

  • The Gephardt Institute’s Civic Engagement Fund includes a Grant to support individuals who have been accepted to a service trip but for whom the cost of their service trip is prohibitive. This is a need-based fund for students who would otherwise be unable to participate.
  • Applications are dueelectronically on February1 5:00pm
  • Learn more at

Memphis Immersion Application Questions

Please type your answers to the following questions on a separate sheet of paper and attach them to your application packet. Answers to each question should be under200 words.

  1. Why do you want to participate in Memphis Immersion?
  1. What does quality civic engagement mean to you?
  1. As you prepare for a service trip focused on civil rights, diversity, and inclusion, please respond to the following quote:

“Any change, even a change for the better, is always accompanied by drawbacks and discomforts.” - Arnold Bennett