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Pathways Inquiry Form

Name

Hometown
MU e-mail address

MC box #
MU phone #

Other phone #
Current classification  

Academic major(s)
Minor

Academic advisor
Expected graduation date

Do you have any activity planned for the summer of 2011, which could prevent you from completing the 10 weeks of service (e.g., wedding, vacation, summer class)?



Session desired


Do you plan to return to MU the semester following the Summer Service Session?




Do you have a working knowledge of a language other than English?



If yes, please indicate which language(s) you speak.

Have you ever studied abroad or gone on a missions trip?



If yes, please list destination, organization/church/school (if applicable) and purpose of the trip


Do you enjoy working with the following populations?







If Other, please indicate

Which of the following populations would you prefer not to work with?


Elderly






If Other, please indicate



Do you have any previous service experience?



If yes, please describe type, length of time, and list organization (if applicable).


Other areas of interest:
What are your career goals?



If you have any further questions about the application process, please contact Carole Miller-Patrick for more information.

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