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2018 Spring Alternative Break Trip Participant Registration Form

This is a registration form to participate in the Alternative Break program.

       *closes February 11, 2018*

Please note that the trip has a participant cap, and will be enforced at a first come, first served basis after the initial deposits have been made.


Attending an Alternative Break is a life-changing experience that can challenge and expand your understanding of yourself and society. To ensure a safe and successful experience for everyone involved, the Alternative Break Program requires dedicated, caring, and active Trip Participants. Trip Participants are expected to:

  • Attend 4 pre-trip departure meetings (time/dates based on participant/coordinator availability).
  • Assist Trip Facilitator with planning and fundraising as needed
  • Be flexible and maintain a positive attitude
  • Effectively communicate with the Trip Facilitator, Trip Advisor, and other Trip Participants
  • Engage in critical reflection before, during, and after trip
  • Remain open to different ideas and perspectives


  • Conservation in the Grand Canyon (3/17-3/24)
    • Deposit: $150
    • Total with deposit: $250
    • Please note that the availability of this trip is based on a minimum number of 4 Trip Participants.
  • Homelessness in San Francisco (3/17-3/24)
    • Deposit: $150
    • Total with deposit: $450
    • Please note that the availability of this trip is based on a minimum number of 4 Trip Participants.

**The spring break trip fee covers emergency funds, food, housing, transportation and Trip Advisor/Trip Facilitator fees. Final trip fees will be confirmed in the Spring Semester.

After completing the Trip Participant Registration Form, please make a $150 deposit to budget number 6753-67531 at the Cashier’s Office. Registration forms and deposits are due Sunday, February 11. Upon making your deposit, please submit your receipt to Melissa Gutierrez, Lead Civic Engagement Assistant, in AF 303. Your registration for an AB trip will not be confirmed until both the Registration Form and receipt of deposit is received.  Final payments are due by Wednesday, February 21.



All participants are required to attend.  At the first meeting, Trip Coordinators will determine if another day/time works for their group of Trip Participants.  These meetings will include time to get to know and build a team with other trip participants, learn more about the issues in which you'll be engaged, and spend time covering logistical and safety issues.


  • Individual - Participants will have multiple opportunities to work as a team on fundraising efforts that can offset the cost of their trip.
  • SGA Conference Sponsorship Application - Individual students may also apply for funding through the SGA Conference Scholarship Application.  This application must be submitted at least three weeks prior to the final payment date in order to receive funding in time to make your final payment.  
  • Other financial assistance may be available.  Please email Justin Koppelman, Associate Director of Student Engagement.


Refunds will only be provided if the trip is canceled by the Civic Engagement Initiatives.  In any other circumstance, deposits/payments are non-refundable.  Students who wish to withdraw from the program after payments have been made will forfeit that money to ensure the stability of publicized trip costs.  Since trip fees are determined by the number of participants, withdrawing from the program and receiving a refund in any amount would result in an increased cost to the remaining participants.

*Student conduct records will be reviewed after the registration deadline has passed, to help ensure a safe environment for all Trip Participants.  Please email Justin Koppelman, Associate Director of Student Engagement, with any concerns you might have about this process.

**Contact Melissa Gutierrez, Lead Civic Engagement Assistant at, if you’d like to discuss the commitment and expectations further. Involvement in Alternative Breaks requires time and energy, but is extremely rewarding!

This form closed on February 11, 2018 11:45 PM PST