Full Name:
    

Student ID#: 

Email: 

Permanent Home Address:



Home Phone: 

Cell Phone: 

Campus Address/CPO Box: 

Gender:  Male  Female
Date of Birth: 
Year at North Park: 1st   2nd   3rd  4th  
Major: 
Minor: 
Native Language: 
What other languages do you speak or study:

Most Global Partnership teams meet in the evenings, late at night, or early morning. Are there any scheduling conflicts or timing concerns you would like us to be aware of? What is your preferred meeting time?

Have you ever been charged with academic dishonesty or received any disciplinary sanctions from the Office of Student Development that you believe might be relevant to your participation in a Study Abroad program? Yes No

If you are applying for an international trip please answer the following:

Are you a U.S. Citizen? Yes No
Do you have a U.S. Passport? Yes No
Passport Number: Expiration Date:
Name as it appears on passport:
If you are not a U.S. Citizen from what country is your passport?

*If you do not currently have a passport, we recommend that you apply for one three months before the trip.

Emergency Contact:
Please explain your relationship:
Emergency Contact Address:
Emergency Contact Phone:
Emergency Contact Email:

Health Insurance Company:
Policy Number:
Group Number:
Company Phone Number:
Do you have any allergies/medical alerts/health concerns/accommodations that you want us to be aware of?  Yes No If so, please explain:

Have you gone on a Global Partnership trip before? Yes No If yes, please tell us about it:

Have you participated in any other service/mission trips or long-term travel such as study abroad? Yes No If yes, please explain:

If you go on a domestic trip, are you willing to be a driver for your team?
Yes No

Do you have a NPU driver’s license?  Yes No

I understand that all team members must raise the entire amount of money for the trip before embarkation.  I agree to help fund our trip with individual and group fund raising projects which may include one or more of the following: letter writing, GP auction, or sales.  Yes No

I understand that I must complete a health waiver form and a liability waiver in addition to this application. (Waivers will be given to you after you have been accepted to a GP team.) Yes No

1. Why do you want to participate in a Global Partnership trip? Specifically, why do you want to go on your desired trip destination?

2. Please tell us a little bit about your faith journey.

3. What do you foresee at the most challenging aspect of this trip? 

4. What do expect to learn from your trip experience? 

5. Please choose one of the following leadership styles that best describes you: motivator, coordinator, teacher, learner, crisis manager, and counselor.  Provide an example of this.

6. What personal and/or group skills do you have (fund raising, cooking, teaching, construction, photography, etc.) that will contribute to your group's success?

7. What extracurricular activities are you currently involved in?

8. What cross-cultural and/or service experiences have you had?

9. How do you intend to raise money for this trip?

Following are the trip agreement stipulations. Please answer each of the stipulations.

1. Meetings - Attend all pre-trip, on-site, and post-trip meetings and activities, including the mandatory trip orientation on either October 4^th (Winter Trips) or January 17^th (Spring and Summer trips.)  Exceptions to this may be granted on a case by case basis by the trip leader and only for extenuating circumstances. Please select your response: I agree I disagree

2. Liability - Behave in ways that are responsible, mature and representative of the best of North Park University. This means compliance with all applicable state, federal, and international laws as well as the North Park University Student Handbook. This includes the no-alcohol policy during college sponsored events. Ignorance of a law is not an excuse or defense. If your behavior is unacceptable or in violation of this agreement, the trip leaders (in consultation with the trip advisor) may terminate your participation in this trip. Termination means you must find your own way home at your own expense, your lodging and reservations will be canceled, and you will not receive a refund of any of your trip fees. Please select your response: I agree I disagree

3. Participation - Initiate and participate in activities that help build community, support learning and allow for personal growth. This may include organizing community meals, leading reflections (i.e., group journals, ecumenical prayer, and discussions), planning games or outings, etc. Stick with the group. Any activities done outside of the structured trip activities are at your own risk. Please select your response: I agree I disagree

4. Reorientation – As an individual or with your group, develop and implement a project to educate others about your experience and what you have learned. Projects could include a video, a slide show, a picture display, assisting with recruitment, doing presentations, etc... Please select your response: I agree I disagree

5. Payment – Payment is in three tiers.  Please turn in 10% of your trip costs within 10 days of acceptance.  Another 25% will be due one month after acceptance.  The final 65% is due on the date specified on the trip webpage (usually one week before your trip.)  You will not be eligible to attend the trip unless you have paid/raised the full amount for the trip. Please select your response: I agree I disagree

6. Cancellation – If for some reason you cannot attend the trip, you are still responsible to pay for any costs that have already incurred. Please select your response: I agree I disagree  

Answering the 6 areas above affirmatively indicates my agreement and understanding of the responsibilities I am undertaking as a trip participant. I also personally assume any risks involved in activities outside of the trip program. Submitting this Trip Agreement form online indicates that I have carefully read and agree to the above conditions.