Apply Now! — Worthington Field Studies

Student Name

First Name

Last Name

Student Email Address

Student Phone Number

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What is your t-shirt size (student)?

Parent or Guardian Name

First Name

Last Name

Parent or Guardian Email Address

Parent or Guardian Phone Number

(###)

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School Student Currently Attends

Student's Graduation Year

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Have you ever participated in a WFSI trip?

Please list the high school science courses you have taken or are now taking, and indicate the year taken, semester grades, and teacher

Please list any science courses you plan to sign up for next year

Do you plan to pursue a college education?

What are your career goals?

In what types of physical activities do you regularly participate?

Are you afraid of heights?

Do you have a fear of water?

Can you swim?

Do you have any allergies?

If you answered "yes" to having allergies, please list them, their severity, and your treatment plan

Do you sleepwalk or sleep talk?

Why do you want to be part of the WFSI 2019 Rockies Trip?

What positive contributions will you make to the group?

How will you benefit or grow from participating in the trip?

What will you do to prepare yourself physically for this trip?

What will you do to prepare yourself mentally for this trip?

Please use this space to give us any additional information you think would be helpful for us to know about you.