Live.Learn.Lakeview

2008-2009

PERSONAL DATA

Name:

Date of Birth:      Year of Entry:    T-Shirt Size:

Contact Information:

Hall/Room:     UR Box:    Campus Phone:

E-Mail:   Cell Phone:

EDUCATIONAL DATA

Major(s):             Minor(s):

Cumulative GPA:                  Classification:

PROGRAM INTEREST (rank only the ones that interest you, 1 being first choice):

Campaign 2008:           Civic Engagement:  Urban America:                 Earth Lodge:

Life, Literature and Art:    Spanish in the Community:

Please answer the following questions completely.  For each program you ranked of interest, complete a separate form.  You will answer all questions for each program of interest.  You can type in the box or e-mail an additional page.

Program of Interest:

Do you have a a preferred roommate also applying for this program?  (Yes/No):

Name of requested roommate:

Why are you interested in becoming a member of this Living-Learning Community?
       

What personal skills, interests, and qualities will you contribute to this program?
       

If you were in charge of an activity or weekend trip for the program, what type of activity would you plan and why?
       

Do you have any vocational, career, or research interests that you believe would be enhanced by your involvement in this class and program?