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Brown University Brown University Brown University Third World Center Home

Third World Transition Program
2008 Registration Form

***In order to participate, this form must be completed by July 31, 2008***

Tuesday, August 26th - Friday, August 29.

Section I

Name:
Gender Identity:

Race/Ethnicity(Please List All):

How do (else) you self identify:

Phone Number:

Date of Birth:

 

Current Address:
City:
State:    Zip Code: 
Email Address:
Fax # (if available):  
Are you a Recruited Athlete?
Yes No If so, what sport?
Religious Background or Affiliation
Emergency Contact Name:  

Emergency Contact Phone #:

Relationship to Participant:

 

Proposed Concentration


Section II

YES, I intend to participate in the 2008 Third World Transition Program at Brown University from August 26th to August 29th.
(Please complete Section III ).
NO, I will not be able to participate in the Third World Transition Program.
(Please complete Section IV).


Section III
If you answered "YES" to Section II, please indicate the following:

Dietary Restrictions:
Request for Religious Services:
(please indicate denomination & we will provide transportation)
Yes No  
Please indicate any disability-related needs that we should be aware of:
(including any medical conditions and/or physical limitations)
Yes No  

Travel Plans: (Note: Tuesday, August 26th is the only day the program will provide pick-up service from the train station, bus station, and T.F. Green Airport)

I plan to arrive for TWTP on August:

via:

at:
: .

If arriving at TF Green, my Airline is and my flight number is .

If arriving by Train, my train number is .


Check here if you need to be picked up at the T.F. Green airport, Peter Pan/Greyhound bus station, or Providence Amtrak station.
Indicate how many pieces of luggage:


I will be arriving [by myself] [with my family/friends]

If with family or friends, please indicate the number:

**If you are planning to attend the Welcome Reception on Tuesday, August 26th at 5pm, please indicate the number of guests [including yourself]:

I would be interested in attending the following information session/s (with my guests):

Campus resource information session (2pm - 2:45pm)

A “Letting Go” session (2:45pm - 3:45pm)

University Financial Planning for Parents (4:30pm - 5pm)

Third World Community at Brown (3:45pm - 4:30)

 

In addition to TWTP, I will be attending:

The Excellence Program

the University Community Academic Advising Program (UCAAP)


Section IV


If you answered "NO" to Section II, for statistical purposes, please indicate your reason(s) for not attending TWTP:
Family Trip Summer Vacation Job No Interest
Non-Flexible Travel Plans Perception of the Program
Other [Please Specify]:
 

**Please note: Housing and meals are provided free of charge to TWTP participants for the duration of the program (August 26th - August 29th). After TWTP, regular meal plan will start (August 30th).