Form

Unschool Adventures - Online Application
To apply for enrollment, please fill out all required boxes in the following form.
After pressing "Submit", you will be directed to PayPal to pay the $30 non-refundable application fee. PayPal accepts all major credit cards.
I am applying for the following trip:*

Asheville Intensive 2012 Sustainable Living 2012 Writing Retreat 2012
Student Information
Student First Name*
Student Last Name*
Student Nickname
Mailing Address*
City*
State
(or Canadian Province)
Zip/Postal Code*
Country*
Home Phone*
Cell Phone
Student E-mail*
Birthdate*
Month Day Year
Age at Start of Trip*
Passport Status*

I have a passport valid for 6+ months beyond the trip ending date I do not have a passport or it will expire within 6 months of trip ending date N/A - I live in the same country where the program takes place
Country of Citizenship*
Adult T-shirt Size*
Primary Guardian Contact Information
(This parent or guardian with legal custody is our primary contact for enrollment, billing, and emergencies.)
First Name*
Last Name*
Daytime Phone*
Evening Phone*
Fax
E-mail*
Relationship (e.g. dad, aunt, guardian)*
If address is different from student's address, please fill in below:
Mailing Address
City
State
(or Canadian Province)
Zip/Postal Code
Country
Second Guardian Contact Information
(This parent, guardian, or other adult is our back-up contact for emergencies.)
First Name*
Last Name*
Daytime Phone*
Evening Phone*
E-mail*
Relationship*
If address is different from student's address, please fill in below:
Mailing Address
City
State
(or Canadian Province)
Zip/Postal Code
Country
Personal Reference
Please provide the name and best contact information for an adult who can comment on the student's character and independence (no family, please).
Name*
Phone or Email*
Health Questions
Is the student, or has the student in the past 24 months been under the care of a physician, psychologist, or psychiatrist? (Ignoring routine check-ups)*

Yes No
Is there any information about the student’s physical or mental health that might have some bearing on his or her trip?*

Yes No
Is the student currently taking any prescribed medications?*

Yes No
If "Yes" to any of the above questions, please provide a short explanation:
Allergies:
Diet:*
Specific Dietary Restrictions:
Student Questions
Please answer the following three questions with 1-2 paragraphs each.
What excites you about this trip, and what do you hope to gain from it?*
What life experiences have prepared you for the challenge of living away from home for an extended period of time?*
What are your major interests? What do you love to do?*
Choose the term that best describes your teenage education.*
Can you navigate a small city or airport on your own?*

Yes No
Can you wake yourself up at a certain time if necessary, and can you keep track of time on your own?*

Yes No
All Unschool Adventure trips are drug, alcohol, and tobacco-free. Do you foresee any problem in complying with this policy?*

Yes No
How did you find out about this trip?*
If you have a coupon code, enter it here:
Writing Retreat 2012 Only
I am interested in the following worktrade(s):

Dinner Dishes Gladiator ($400) BLS Goddess ($400)
Submission
Privacy Policy : Unschool Adventures only uses application information for contacting parents/guardians concerning enrollment, billing, or emergencies. We respect your privacy and do not share information with third parties.
When you are ready to apply, please click "Submit." A copy of your information will be e-mailed to the student and primary parent/guardian .
Should be Empty:

Unschool Adventures - Online Application

Student Information

Primary Guardian Contact Information

Second Guardian Contact Information

Personal Reference

Health Questions

Student Questions

Writing Retreat 2012 Only

Submission