- Step 1 of 3

Semester Season *

• Fall
• Spring

Gender *

• Male
• Female

Name *

First

Last

Address

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Email *

Home Phone

Mobile Phone *

Age at Time of Semester

College / University

Major / Minor

Year in School

• Freshman
• Sophomore
• Junior
• Senior

Next

First Reference

Name *

First

Last

Email *

Phone *

Relationship *

Second Reference

Name *

First

Last

Email *

Phone *

Relationship *

PreviousNext

Why do you want to attend our semester program? Describe three things you expect to gain from this semester.

What or who are your major influences in your life at this time? Why?

What or who are your major influences in your life at this time? Why?

What is your understanding of experiential education?

What does the term “service” mean to you?

How would you describe yourself?

What previous wilderness / outdoor pursuit experience do you have?

Describe your faith in God.

How did you find out about Summit Adventure's semester program?

Phone

Submit