Application

Name:

Current Address
Street:
City:
State: Zip:

Phone:

E-mail address (Penn preferred):

Campus Address (if known)
College House:
Building name:
Room number:

Cell Phone:

Penn ID number (This is an 8-digit number in bold on your PennCard. You can also find it in your PennKey setup letter, or on CampusExpress if you set up your PennKey. Otherwise leave blank):

School and Academic Major:

Hobbies/Special Interests:

T-shirt size:

Optional Demographic Information:

Race/Ethnicity:

Gender:

Religion:

Are you taking any medication? If yes, please specify:

Are there any medical conditions of which we should be aware? If yes, please specify:

Do you know anyone who participated in PennQuest? Who?

Please respond thoughtfully to the following questions. (Hint: we don't need you to write a book to answer these short essays, but the answers should show effort and enthusiasm).

1. Why are you interested in participating in the PennQuest Program and why do you think you would be an asset to the group?

2. Although not required for participation, please list all of your previous outdoor experiences. (Don't worry if your last outdoor experience was a walk in the park. Motivation is what we have in mind.)

3. Please answer ONE of the following two questions.

If you had 24 hours in which you could do anything you wanted to do without any restrictions including normal human limitations, what would you do on this perfect day?

OR

If you could have any three people on your personal squad to face life's extraordinary adventures, who would they be and why? Please keep in mind that you can include real, fictional, historical, and deceased people.

Choose one:
I am applying to this pre-orientation program only.

I am applying to more than one pre-orientation program. My preferences in order are:

1.
2.
3.
4.
5.

I understand the PennQuest program is scheduled from Sunday, August 30 - Thursday, September 3, 2009. The cost of the program is $350.00 which I agree to pay immediately upon receipt of the acceptance packet. **

** Note: For those students eligible for financial aid through the University of Pennsylvania, limited financial assistance is available. Please indicate if you wish to be considered.

Yes, I am eligible for financial aid through Penn and wish to be considered for financial assistance to support my participation in the PennQuest program. (Any type of financial aid or work-study through the University qualifies).

Please submit your application by June 30, 2009. If you have questions, feel free to write Laurie McCall in the Platt Student Performing Arts House .