Winter Break Sites: Exploring Socioeconomic Impacts on the Public Education System in Denver, Colorado Evaluating the Root Causes of Homelessness and the Various Programs for Relief in Fort Worth, Texas Gaining Empathy and Understanding for Native American Populations in Talequah, Oklahoma For Academic Year 2015-2016 Wildcat ID # Name Date of Birth: ___/___/______ Class: FR SO JU SR Grad Age: Total hours of college credit completed ________ Are you a U.S. Resident? Yes No Cumulative GPA If no, country of residence______________ Major(s) Are you a Kansas Resident? Yes No Minor(s) Do you speak a foreign language? Yes No E-mail Address If yes, list language(s)__________________ Will you accept any site placement? Yes No Are you willing to attend site leader meetings and weekly Please indicate your site preferences, if any training? Yes No ______________________________________________ _______________________________________ Signature: ____________________________________________ Date: ______________________________
Winter Break Sites: Exploring Socioeconomic Impacts on the Public Education System in Denver, Colorado Evaluating the Root Causes of Homelessness and the Various Programs for Relief in Fort Worth, Texas Gaining Empathy and Understanding for Native American Populations in Talequah, Oklahoma For Academic Year 2015-2016 Wildcat ID # Name Date of Birth: ___/___/______ Class: FR SO JU SR Grad Age: Total hours of college credit completed ________ Are you a U.S. Resident? Yes No Cumulative GPA If no, country of residence______________ Major(s) Are you a Kansas Resident? Yes No Minor(s) Do you speak a foreign language? Yes No E-mail Address If yes, list language(s)__________________ Will you accept any site placement? Yes No Are you willing to attend weekly site leader meetings and Please indicate your site preferences, if any training? Yes No ______________________________________________ _______________________________________ Signature: ____________________________________________ Date: ______________________________
2016%20Participant.docx