AMERICAN ODYSSEY
PARTICIPANT APPLICATION
PERMANENT ADDRESS



SCHOOL ADDRESS
Name _________________________________________________
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 ________________________
GPA ________
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