SERVICE

M.A.P.

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Basic Information

Name: *

Student MUID: *

Marquette address: *

ZIP code: *

Phone: *

Email: *

College year: * Please select... Freshman Sophomore Junior Senior Grad Other

Anticipated graduation (year): *

Birthdate: *

Emergency Contact Information:

Name: *

Relationship: *

Address: *

City, State, ZIP code: *

Day phone: *

Night phone: *

Health Information:

Any medical conditions/allergies? * YesNo

Please describe:

Dietary limitations? * YesNo

Please describe:

Do you have health insurance? * YesNo

Insurance provider:

Policy number:

Insurance phone:

Driving Information:

Are you willing to drive? * YesNo

Are you van trained for the university? * YesNo

Driver's license state:

Driver's license number:

Expiration:

Let us know you better:

Why do you wish to participate in M.A.P.? *

Describe an interaction where you have done service for others. *

What has influenced your decision to participate in M.A.P. *

What do you hope to get out of M.A.P. *

M.A.P. Locations:

First choice: * Please select... Urban Poverty - Catholic Worker House Urban Poverty - Fr. McKenna Center Urban Poverty - Franciscans for the Poor Urban Poverty - Kansas City Rescue Mission Urban Pocerty - MadCAAP Rural Poverty - Ivanhoe Civic League Rural Poverty - Tantré Organic Farm Human Dignity - Aid for Women Human Dignity - L'Arche Human Dignity - Pine Ridge Reservation Human Dignity - Resurrection Catholic Church Education - Brooklyn School for Collaborative Studies Education - De Lasalle Nativity School Education - Readiness Center Education - Smithson Craighead Academy Build/Rebuild - Habitat for Humanity Build/Rebuild - Rebuild Joplin

Second choice: * Please select... Urban Poverty - Catholic Worker House Urban Poverty - Fr. McKenna Center Urban Poverty - Franciscans for the Poor Urban Poverty - Kansas City Rescue Mission Urban Poverty - MadCAAP Rural Poverty - Ivanhoe Civic League Rural Poverty - Tantré Organic Farm Human Dignity - Aid for Women Human Dignity - L'Arche Human Dignity - Pine Ridge Reservation Human Dignity - Resurrection Catholic Church Education - Brooklyn School for Collaborative Studies Education - De Lasalle Nativity School Education - Readiness Center Education - Smithson Craighead Academy Build/Rebuild - Habitat for Humanity Build/Rebuild - Rebuild Joplin

Third choice: Please select... Urban Poverty - Catholic Worker House Urban Poverty - Fr. McKenna Center Urban Poverty - Franciscans for the Poor Urban Poverty - Kansas City Rescue Mission Urban Poverty - MadCAAP Rural Poverty - Ivanhoe Civic League Rural Poverty - Tantré Organic Farm Human Dignity - Aid for WOmen Human Dignity - L'Arche Human Dignity - Pine Ridge Reservation Human Dignity - Resurrection Catholic Church Education - Brooklyn School for Collaborative Studies Education - De Lasalle Nativity School Education - Readiness Center Education - Smithson Craighead Academy Build/Rebuild - Habitat for Humanity Build/Rebuild - Rebuild Joplin

I am willing to go anywhere: * YesNo

Reason for first choice: *

Please list any prior M.A.P. trips you have been on: *

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Campus Ministry

The office of Campus Ministry is located in room 236 of the Alumni Memorial Union. A dedicated staff is available throughout the day to provide you with a wealth of information. If you are searching for a worship space, they can help you find a suitable space on or off campus. They can also inform you of the many service opportunities we offer. Read More ...