Date of Birth*
Year in School
Languages spoken other than English (optional)
Have you been on an immersion trip before?
If yes, when and where
Would you like to be considered for financial assistance?
If yes, please provide your student ID #
Is there anything special we should know about you?
Emergency Contact 1
Emergency Contact 2
Please give short responses to the following questions. We hope you take some time to reflect on the questions before answering them. There are no “right” answers; please be honest and share your thoughts with us. You may want to type the answers in a Word document and paste them into the boxes below.
1. Please describe one or two service experiences you’ve had. What made the experience(s) meaningful to you?
2. What skills and/or perspectives would you bring to the group?
3. Please indicate the immersions for which you would like to be considered by ranking them from 1 (most desire) to 3 (least desire). If there are immersions for which you would not like to be considered, please do not include them in your choices.If you are applying for an SUYI Weekend Immersion, please note which trip you would like to be considered for.
4. Please share your reason(s) for being interested in these immersions.
5. What do you hope to learn through participating in one of these immersion trips?
In order to make our service immersion together as smooth, safe, and enjoyable as possible, we ask all participants and leaders to consider the following guidelines for living and serving together:
You are asked to fully participate in all aspects of the immersion, including reflection, cooking and cleaning. During reflection, you may “pass” at any time and participate by actively listening to others.
All CSCE activities are drug and alcohol free. No participant or leader will consume or carry alcohol or drugs during the trip. This includes any time spent in the residence halls prior to departure and upon return from the service immersion. Any student who is found with substances other than prescribed or over-the-counter medication will be sent home at his/her own expense.
We hope that our immersion trips provide cross-cultural experiences that stretch our comfort zones, question our assumptions, and expand our perspectives. You may feel uncomfortable being in a new environment and engaging with new people. If you feel unsafe or if you are asked to do anything that runs counter to your value system or if you feel you are being harassed, notify the trip leaders immediately.
During the service immersion, you will be part of a community of people serving and learning together. For the purpose of creating a safe, stable and cohesive community, you are expected to stay with the group at all times. Appointments and other engagements should not be scheduled during the immersion trip. Any activities that the group decides to do together will be connected to the purpose of the trip. For example, going shopping for clothes, checking email, and going clubbing will not be a part of the immersion experience. Additionally, in order to maximize your experience, we ask that you keep cell phones turned off, packed in your bag, or left at home while the immersion is taking place.
The immersion experience is intentionally designed to model simple living. Simple living means that we try to live in a way that limits our negative impacts on the global community and the environment as much as possible. This means keeping our food costs low and letting go of some of the luxuries (e.g. ice cream and other snacks) that we take for granted. We also are conscious about the natural resources (paper, plastic, heat, electricity, etc.) that we use.
SU Nondiscrimination Policy: This program is available to all students without regard to race, color, religion, sex, national origin, age, disability, marital status, sexual or political orientation, or veteran status. Students requiring special accommodations should contact Disabilities Services at Loyola 100, campus extension 5740.
I confirm that the information contained in this application is factual and a realistic assessment of my abilities. I will notify CSCE if any of the information I have provided changes. I have read, understand and agree to uphold the Guidelines for Participating in CSCE Immersion Trips and the Student Code of Conduct.