PERMANENT ADDRESSSCHOOL ADDRESS
Address _______________________________Address _____________________________________________
Phone _______________________________ Phone ________________________________________________
E-Mail _______________________________ E-Mail ________________________________________________
Age ____________Birthday ____________________Shirt Size: ________________ Teaching Fellow Yes No Freshman Sophomore Junior Senior (as of date of trip) Professor that knows you well ________________________________Major ________________________
Clubs, Extra Curricular Activities in the last 3 years You Participate in at School(School or Community) List Qualifications you feel that List Hobbies and Interests you possess for this trip
How do you feel others see you?
If you are accepted, what will the other participants like most about you?
If you are accepted, what will the other participants like least about you?
Please give three reasons why YOU really want to go on this trip
Name and address of a friend who you would like to have apply for the trip:
On the back of this sheet you may write anything about yourself or include (attach)anything that may help the selection committee reach their decision concerning your participation.
Please include two letters of recommendation . . . One from an adult friend or professor and the other from a peer.
______________________________________________________________________________________ Parent Signature Applicant Signature ___________________________
Please forward this application to:
David Barlow * American Odyssey
P.O. Box 198 Landis, NC 28088
Phone: (704) 855-2511
Please indicate which Experience this Application is being Submitted for.