Applied Date *

Country * Canada

Last Name *

First Name *

Preferred Name

Email *

Alternate Email *LEAVE BLANK IF NONE

Mobile (no dashes or parenthesis) *

Date of Birth (MM/DD/YYYY) *

CAN University * Brock University Carleton University Concordia University Dalhousie University McGill University McMaster University Memorial University of Newfoundland Queen’s University at Kingston Simon Fraser University Toronto Metropolitan University (formerly Ryerson) Université de Montréal Université de Sherbrooke Université du Québec (UQ) system (general) Université Laval University of Alberta University of British Columbia (UBC) University of Calgary University of Guelph University of Manitoba University of New Brunswick (UNB) University of Ottawa University of Regina University of Saskatchewan University of Toronto University of Victoria (UVic) University of Waterloo University of Windsor Vancouver Island University Western University York University Other

University Other (Not Listed In Dropdown)

Graduation year

Year in School 1st Year 2nd Year 3rd Year 4th Year 5th Year

Major

Application Statement

Trip Interest (command to multiselect) Around the World in 60 Days Central America Southeast Asia East Africa North America Tanzania Zanzibar Nicaragua Costa Rica Thailand Laos USA: Hawaii WILD: Outdoor Leadership & WFA Course Private Trip Undecided

Did they see GIVE on social media? * Yes No

Applied in Meeting * truefalse

Rush Accept! TrueFalse

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