Johns Hopkins University School of Nursing and SOURCE (Student Outreach Resource Center)

“SEEK: Action, Reflection, and Transformation” Service-Learning Immersion Experience

Participant ApplicationBALTIMORE, MD

The School of Nursing and SOURCE are excited to announce applications for the SEEK Service-Learning Immersion Program. SEEK participants will be engaged in a Alternative Winter Break experience where they will conduct direct service activities while learning about the social issue and location in which the immersion takes place. Information Session: Wednesday, December 4th from 12:00-1:00pm, School of Nursing Room 310.

What will you be working on? Projects will vary throughout the week, as determined by organizational needs. Organizations that students will possibly work with include: Habitat for Humanity, Civic Works, Moveable Feast, Amazing Grace Lutheran Church, and local areas school. Service projects could include building projects, community beautification, greening projects, etc. You will be working with several SOURCE partner organizations (directory of CBOs can be found at www.jhsph.edu/source ).

What will you learn? You will hear from various speakers and community leaders about the history of Baltimore City with a strong focus on East Baltimore, the issues the city faces and the great work people are doing to address those issues. You will also learn how to get more involved in the city. Students who participate in this trip will also participate in a pre-trip and post-trip workshop. The pre-trip workshop takes place on Thurs, Dec 12th from 5:30-8:30pm.

When will this take place? Mon, Jan 20th-24th, 2014 (date has been changed)Special note for PUBLIC HEALTH applicants: We have decided for certain reasons to change the dates to Jan 20th-24th, unfortunately this means that JHSPH students are not eligible to join because of classes. We apologize for the inconvenience.

How much will it cost? $100-150

What does the cost include? This cost covers transportation, food, and any fees related to the trip such as museum entries, tour costs, etc.

Important Cost Information: SEEK Participants are responsible for the entire cost of their trip. Final program costs will be due on Thurs, Dec 12th (at the pre-trip workshop).

To Apply: Application due date: Monday, December 9th Fill out following application in full. Submit with a $100 deposit to hold your space on the trip (make check out to: Johns Hopkins University ) Students will be contacted regarding their application and next steps soon after the due date. Return completed applications to source@jhsph.edu. Send to or drop deposit check off at SOURCE at 2017

E. Monument St, Baltimore, MD, 21205. Applications will only be considered complete once the deposit check has been received.

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SEEK Participant ApplicationBALTIMORE, MD

Send completed profile form to source@jhsph.edu. Send $100 deposit to SOURCE at 2017 E. Monument St, Baltimore, MD, 21205

by Monday, December 9 th .

(Please Print or Type)

Name:                                                                                                                                                                                                                                                                                                                                                   First                                                        Middle                                             Last Current Mailing Address:                                                                                                                                                                                                                                                                                                                                                              City:                                                                                                                                                                            State:                                      Zip Code:                                                      Daytime Phone:                                                                    Evening Phone:                                                                   Cell Phone:                                                              Email:                                                                                                                                                             DOB:                                                                                                              Gender:     M            F

School: ___________________________________ Program/Department: ___________________________

Degree Sought: ____________________________ Expected Completion Date: _______________________

How did you hear about this program? _________________________________________________________

                                 Goal Statement: Please state in the space below your interest in the specific opportunity you are applying for the SEEK Service-Learning Immersion and your goals for participating.

Previous Community Service Experience: Please list below any community service or volunteer experience you have had, the reason you were involved in it, and lessons learned from your experience.

Briefly describe how you see yourself as flexible and / or how you deal with challenging situations.

Are you available for the Thurs, Dec 12th pre-trip workshop (5:30-8:30pm)? Yes/No (if no, please indicate why)

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