EmailMe Form - Alternative Spring Break March 22-27, 2016

Alternative Spring Break March 22-27, 2016

This application is for those wishing to participate in the 2016 Alternative Spring Break workshop that will be held March 22nd to March 27th. The trip will take you on a “road trip” through many significant areas in the southeastern United States. The trip begins in New Orleans, Louisiana and stops will be made in Mississippi and Alabama. The trip will end in Montgomery, Alabama where Dr. King and the Southern Leadership Conference helped to facilitate the Montgomery Bus Boycott.

More information may be found on the ASPCC Website www.pcc.edu/resources/aspcc/district-student-council/ but you must apply online by the deadline (December 10th) to be considered for this opportunity.

Civic Engagement logs are due January 5th.

Civic Engagement hours must be done during Fall Term 2015. Hours can not be applied retroactively.

Learning Outcomes:
Students participating in PCC’s Alternative Spring Break “Civil Rights Movement Road Trip” will

• Gain knowledge related to the trajectory of the Civil Rights movement in the United States by traveling to the Southeastern United States and visiting landmarks, memorials, and museums that honor the work and history of the struggle for equity in our country.

• Identify the benefits and challenges of diversity in American life by engaging in intentional dialogue after each presentation or site visit.

• Recognize the names of the key people, players, places and events in the movement by listening to a variety of presentations and site visits from the eras of slavery, reconstruction and the civil rights era.

• Gain awareness of racism and how it has influenced our society and be able to apply the knowledge gained on the “road trip” to current situations and struggles of marginalized populations by creating a display for each campus “Civil Rights” fair spring quarter 2016.

Qualifications:

In order to participate in Alternative Spring Break 2016 “Civil Rights Road Trip” students must meet the following requirements and complete the outlined tasks.

• Be a student in good standing
• Submit your application by December 10th using the online application only.
• Pay the $400 fee (make checks payable to ASPCC) by December 10th at 5PM. There may be an opportunity to fund raise for the trip. You will need to organize with the Student Leadership Program professional staff in September if you wish to engage in fundraising opportunities.
• Agree to the guidelines and expectations for attendees (turn in signed document with application)
• Complete 10 hours of service by January 5th, 2016. Service hours/logs must be emailed to leadership.ca@pcc.edu no later then January 5th at 5PM to be considered.

Name *
Current GPA *
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Phone Number *
### - ### - ####
Birth date *
MM / DD / YYYY
MyPCC Email *

Confirm
Student Leadership Affiliation. You may select more than one. *
Club Leader/member
Resource Center
ASPCC
Please list one campus reference who can speak to your leadership on campus. For example a staff or faculty advisor, your immediate supervisor, or the president or leader of your club.
Name (Reference I) *
Title (Reference I) *
Phone (Reference I) *
Email (Reference I) *
Please answer the following five questions.
Answers should be prepared in a word process program and uploaded. Click the button below to up load your essays. Each answer should not be longer than 500 words.

Please be sure your name is on all uploaded documents.

1. Why do you want to participate in the 2016 Alternative Spring Break “Civil Rights Road Trip”?

2. Tell us about your experience advocating for marginalized populations? How did you engage in this advocacy work? What did you learn?

3. How will you share your experience in on this trip with others?

4. What is the significance of the Civil Rights Movement to leadership at Portland Community College?
Upload your Answers
Upload only .doc or .pdf files *
Advocacy and Civic Engagement Volunteer Log
In order to participate in the 2016 Alternative Spring Break trip, you need to complete 10 volunteer hours before January 5, 2016. The volunteer hours need to be tied to some form of advocacy through civic engagement. Your volunteer experience may be partisan (for example, you can volunteer for a political campaign for an individual or a cause that may reflect a particular point of view). Or, you can work for a group that advocates for equity and inclusion (Basic Rights Oregon, for example).
Supervisor Name (someone who can attest to the service work you did for at least 10 hours)
First Last
Volunteer Supervisor Email
Volunteer Supervisor Phone
### - ### - ####
A brief desciption of what your volunteer experience was or will be if it is not complete yet.
Answers should be prepared and uploaded using a word process program. If you submit your application to meet the deadline and this part is not complete, you may email your answers to leadership.ca@pcc.edu by January 5th at 5PM.

Describe the work you did to complete your 10 hours of volunteer work?

What did you learn about the issue or cause you worked on Fall Quarter 2015?

Upload only .doc or .pdf files
Verification
Read and check each box

in order to participate in Alternative Spring Break 2016 “Civil Rights Road Trip” students must meet the following requirements and complete the tasks. *
I will be enrolled in at least six (6) credits per term at PCC for the entire 2015-2016 school year.
I will maintain at least a 2.5 GPA and successfully pass my classes.
Submit my application by December 10th using the online application.
Pay the $400 (checks to ASPCC) to your campus Student Leadership Coordinator before the deadline of December 10th at 5PM. If you would like to fundraise please work with your campus ASPCC Office.
Complete 10 hours of service as outlined in this application by January 5th, 2016 and email the completion information to leadership.ca@pcc.edu if it was NOT submitted with this application. My service hours must be from Fall 2015.
If chosen to attend, I will participate in all aspects of the trip with a positive and appropriate attitude.
Trip leaders will accommodate my food needs or other reasonable needs if they know in advance. I will not impose personal preferences on the staff planning the trip.
While in a learning session, I will turn off my cell phone and engage.
Failure to meet requirements may result in my being sent home early from the trip, and I may have to repay ASPCC for expenses.
If chosen to attend I will travel with a large group of people (50 participants) and I understand that things take longer, I must be flexible, and remain positive.
Signature
Clear

Please list one campus reference who can speak to your leadership on campus. For example a staff or faculty advisor, your immediate supervisor, or the president or leader of your club.

Please answer the following five questions.

Advocacy and Civic Engagement Volunteer Log

Verification