LandSea Leader Survey – LandSea

Name *

First Last

Student ID # *

Email *

Summer Address *

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Dates that you are at this summer address *

Phone *

T-Shirt Size *

Our trainings in June will occur after normal on-campus housing move-out and will require us to request approval to remain in your housing. Do you currently live in on-campus housing? *

Yes
No

Dietary Considerations *

Please list any preferences, allergies, or restrictions. If an allergy – please describe the allergy (contact, airborne, ingested, etc.) and your reaction & severity.

Summer Availability

Will you have regular access to email during the summer? *

Yes
Limited
No

Will you have regular access to a phone during the summer? *

Yes
Limited
No

Please specify dates that you will NOT have phone or email access (if applicable).

Driving Certification

Are you already certified to drive a K Fleet car, minivan, or 12-passenger van? *

Yes
No
Not sure

Will you be at least 21 years old by July 1? *

Yes
No

Do you have any moving violations (tickets) or car accidents (where you shared some fault) on your driving record in the last three years? *

Yes
No