nuSERVES 2012 First-Year Team Member Application

Before completing this application please make sure that you reviewed the program information and sample schedule for nuSERVES 2012 located on the Center of Community Service website (www.northeastern.edu/communityservice). Please note you must complete this application at one-time, you cannot save and return to complete.


NAME
NU ID
Home Address
Home Phone
Cell Phone
E-mail Address
Birthdate (MM/DD/YY)
Gender
T-shirt Size:
Dietary Needs or Concerns
Allergies or other Health Concerns
Other Concerns or Special Accomodations

Emergency Contact Name
Relationship to You
Primary Phone Number
Alternate Phone Number
E-mail Address

Please complete short answer essay questions in 500 words or less.
Please describe your interest in applying
to be a member of nuSERVES 2012.
Team work is essential to the nuSERVES
program. Please provide an example
of when you were involved in a team setting
and lessons learned from that experience.
If you could create a community service
super hero, what powers would s/he use
to change the world?
Provide a summary of volunteer and/or
relevant high school extra-curricular
activities.

By pressing submit, I certify that the information provided herein is true and my own. I certify that I am an incoming first-year student to Northeastern University entering fall 2012. I have read and understand the nuSERVES program fee payment and refund requirements and program information for nuSERVES 2012. I understand that I must attend or have attended a NU Summer Orientation session to be eligible for participation. I understand that students in the Honors Program are not eligible due to the conflict with Honors Welcome Week (Honors students will have the opportunity to participate in the Honors Outreach Project). I agree not to schedule or plan any programs or events during the week of nuSERVES, Monday, August 27 - Friday, August 31, 2012.