Rostro de Cristo Application

Personal Information

First Name:

Last Name:

Gender:

Male
Female

Local Address:

City:

State:

Phone:

Phone Type:

Email:

Loyola ID Number:

Personal Information for Students

Graduation Year:

GPA:

Major/Minor:

Support Information

It is helpful to understand the supportive network of individuals who serve as sources of encouragement and motivation for our applicants. Please provide information as appropriate.

Father's Name:

Father's Address:

Father's Contact Number:

Father's Email:

Mother's Name:

Mother's Address:

Mother's Contact Number:

Mother's Email:

Other's Name:

Other's Relationship to Applicant:

Other's Address:

Other's Contact Number:

Other's Email:

Short Answer Questions

How did you hear about this experience?

Please describe any experiences you have had outside the United States.

Please mention any questions or concerns you have about the trip.

In what activities are you involved on campus?

Please list any commitments for the 2012-13 school year (both fall and spring).

Are you studying abroad in the spring of 2013?

Essay Questions

Each essay should be no more then 300 words. Upload your file in Word 2003 format or Rich Text format and save your files as yourfullname.doc.

What is your motivation to apply for the immersion to Duran, Ecuador?

What would you like to learn from this experience?

You will be asked to take part in daily reflection on your own spiritual journey. Please explain how you express your relationship with God and or where you view yourself on your own spiritual journey.

Upload:

Application Conditions

Rostro de Cristo 2012-13 Expectations:

I understand and agree that my attendance at ALL weekly meetings and events (Berger Cookie Challenge, Education Night, other events deemed mandatory) is mandatory. I understand that I am responsible for providing advance notice to one of the trip leaders if I have an emergency, and may be late or unable to attend a meeting or other event.
I understand that fundraising, both as a group and as an individual, is required in order to cover the costs of the trip. This includes my participation in the individual and any group fundraising events/efforts.
I agree to pay a $250.00 program fee upon acceptance to the delegation.
I understand that all funds raised for Rostro de Cristo are non-refundable. In the unlikely scenario that I drop from – or am asked to leave - the RdC Immersion Group, the funds that I have raised will be applied to the overall cost of the program or donated to the host organization (Rostro de Cristo). I know that Loyola University Maryland cannot return donations to individuals or groups.
I agree to submit a photocopy of my Passport and completed Health and Liability forms by January, 31, 2013. If I do not currently have a passport, I agree to complete applications and receive a valid U.S. Passport no later than January 31, 2013.
I understand that my active participation is vital to the formation of the team. I will positively contribute to all team activities and take presentations and reflection assignments seriously.
While in Ecuador, I understand that I will not be permitted to leave the group at any time. I understand that I am subject to Loyola University Maryland’s student code of conduct while I am abroad in Ecuador with the group and that any such violation of the code of conduct may result in my immediate removal from the host country and departure to the United States.

Applications are due by Monday, Nov. 5, 2012, at 5 p.m.

I have read, understand and agree to the details and requirements of the program I have applied for.

Reference #1 Details

Reference Name:

Reference Email:

Reference #2 Details

Reference Name:

Reference Email:

Signature

I, the Applicant:

reserve the right to request review of this reference letter.
waive my right to request review of this reference letter.

Please enter your full name to act as your digital signature:

Campus Ministry

Rostro de Cristo Application

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