Alternative Breaks Application

Thank you for your interest in Alternative Winter Break - Sunday, January 5 - Saturday, January 11.

ETSU's Alternative Break program this year seeks to focus on the multifaceted impact of natural disasters through five key lenses: health and human services, housing, economics, public policy and advocacy, and the environment. Participants will engage directly with communities affected by natural disasters, gaining hands-on experience in disaster response, recovery, and preparedness.

This experience will take students to the heart of federal disaster policy, exploring the intersection of government, legislation, and emergency management. Participants will engage with policymakers and explore how decisions made in Washington, D.C. shape disaster responses nationwide.

This Winter Break, ETSU Alternative Breaks is exploring:

Capitol Crisis: Policy, Power, and Disaster Response (Washington, D.C.)

Please complete the application below to begin your Alternative Break journey!

For more information or questions, please reach out to our team at altbreaks@etsu.edu.
Name*

Preferred First NameLast Name
Pronouns*
E Number*
E001234567
ETSU Email*
bucky@etsu.edu
Phone Number*
Please enter a valid phone number.
Date of Birth*

MonthDayYear
01/01/2001
Classification*

FreshmanSophomoreJuniorSeniorGraduate StudentOther
What is your major or area of study?*
Ex: Public Health or Masters in Counseling
Expected Graduation*
Ex: Spring 2024
How do you identify?*

FemaleMaleNon-BinaryTransPrefer Not to ShareOther
How do you identify?*

African American / BlackAmerican IndianAsianHispanic / Latino/aWhiteMultiracialPrefer Not to ShareOther
T-Shirt Size*

XSSMLXL2XL3XLOther
Do you have any special dietary restrictions? (Ex: Vegan, Vegetarian, No Pork, No Dairy, etc.)
ETSU's Alternative Breaks program makes every effort to ensure that students with different abilities can participate successfully in AB experiences. Please be aware that we cannot guarantee that facilities or support services will be available at each site in the same range and quality as on the ETSU campus. We encourage students to share with us any requests for accommodations that will best allow full participation in an Alternative Break experience.
Previous Experience and Knoweldge

Please note: the below questions are asked to better gauge a participant's prior knowledge and understanding of topics related to social justice, active citizenship, and community service. Prior knowledge and experience with these topics are not required for participation in an Alternative Break.
How did you learn about ETSU Alternative Breaks?*
Have you participated in an Alternative Breaks experience before?*
If yes, please describe:
If no, have you ever participated in any other volunteer/community service project(s)? If so, please describe:
What do you hope to gain from participating in an Alternative Break experience?*
What personal attributes, character strengths, or skills do you possess that will make you a valuable member of an Alternative Break team and will contribute to the community in which you serve? (1-2 Paragraphs Max)*
Please share about your understanding of active citizenship and how it relates to social, racial, economic, environmental, educational, gender, and/or identity topics. (1-2 Paragraphs Max)*
Financial Commitment and Cancellation / Refund Policy

The costs associated with Alternative Breaks experiences are $250, which includes all components of the experience. The cost covers transportation, lodging, and three basic meals a day for the week. Every effort is made to keep costs for students as low as possible. Details regarding payment due date will be shared with participants upon acceptance.

If you have any questions or foresee any financial hardship that would prohibit participation in Alternative Breaks, please contact us at altbreaks@etsu.edu.
I understand that I am obligated to pay the full amount of my trip prior to traveling. If someone other than me (Ex. A parent or guardian) will contribute financially towards my trip, I have spoken with them prior to the submission of this agreement. They are fully aware of my financial obligation.*
Please type the date to confirm your acceptance.
Participation Policy

All experiences begin and end on ETSU's campus. Participants are expected to travel and remain with the group at all times for the entire duration of the experience. This includes attending all pre-trip and post-trip meetings and activities. These meetings will be scheduled by your group once selected.

If you have any questions or foresee any hindrances meeting these time commitments, please contact altbreaks@etsu.edu.
I understand that I am required to attend and participate in all pre-trip meetings, service and educational activities during the experience, and all post-trip reorientation meetings and activities.*
Please type the date to confirm your acceptance.
Alcohol and Drug Policy

In order to ensure both a safe and impactful experience for all participants, ETSU's Alternative Breaks program has a strict policy regarding the use of alcohol or drugs during any portion of an Alternative Breaks experience including pre-trip and post-trip meetings.
I understand that it is the policy of ETSU's Alternative Breaks program that all participants, site-leaders, and learning partners remain alcohol and drug free during the entirety of the Alternative Break experience. Violation of this policy will result in my termination from the program and may require me to return home immediately, bearing the full financial responsibility for doing so.*
Please type the date to confirm your acceptance.
Is there any additional information you would like to share with the Alternative Breaks team?
Should be Empty: