SeriousFun Travel Stipend Application

Please complete the essays in less than 250 words.

Question Title

* 1. Contact Information:

Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

Question Title

* 2. Chapter:

Question Title

* 3. College/University Name:

Question Title

* 4. Camp Name:

Question Title

* 5. Supervisor Name:

Question Title

* 6. Supervisor Phone:

Question Title

* 7. Start Date of Service:

Date / Time

Date

Question Title

* 8. End Date of Service:

Date / Time

Date

Question Title

* 9. How can this relate to your experience with Phi Kappa Tau?

Question Title

* 10. What moment has the biggest impact on you and why?

Question Title

* 11. What will you take away from this experience?

Question Title

* 12. How can this experience be used in your everyday life?

Question Title

* 13. Photo Upload:

Although not required, if you have a photo of yourself at camp or a professional (composite) headshot please submit it here. Submitted photos may be used in print and/or digital promotional materials. By submitting a photo, you give Phi Kappa Tau permission to use your photo. If you have additional photos, they can be emailed to communications@phikappatau.org

PDF, JPEG, JPG, PNG, GIF file types only.

Choose File

Question Title

* 14. Travel Receipts:

You are limited to 5 documents. Please combine multiple receipts into a single document. You must upload your documents in PDF, JPG or PNG formats.

PDF, DOCX, DOC file types only.

Choose File

Question Title

* 1. Contact Information:

Question Title

* 2. Chapter:

Question Title

* 3. College/University Name:

Question Title

* 4. Camp Name:

Question Title

* 5. Supervisor Name:

Question Title

* 6. Supervisor Phone:

Question Title

* 7. Start Date of Service:

Question Title

* 8. End Date of Service:

Question Title

* 9. How can this relate to your experience with Phi Kappa Tau?

Question Title

* 10. What moment has the biggest impact on you and why?

Question Title

* 11. What will you take away from this experience?﻿﻿

Question Title

* 12. How can this experience be used in your everyday life?

Question Title

* 13. Photo Upload:

Question Title

* 14. Travel Receipts:

Question Title

* 15. Requested Amount reimbursed:

* 11. What will you take away from this experience?