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# ______
CAMP “REPUBLIC”
August 10th – 16th (?)
APPLICATION FORM
1. Contact Information
Name (first and
last):
Date of birth:
Address:
Cell/Home
phone #:
E-mail address:
2. University Information
Institute/
University
attending:
Specialization:
Year of study:
1st
2nd
3rd
4th
5th
3. Rate your level of English ability in
My Self-rating of my ability in
SKILL AREA
Excellent
Good
Fair
Poor
Listening
Speaking
Reading
Writing
4. In order to participate in Camp Republic, you must accept the terms and conditions of the camp.
Campers should refrain from any use of drugs or alcohol; any students caught with these substances
or under the influence of them will be immediately removed from the camp at their own expense. No
campers can visit cabins with campers of the opposite sex after bedtime hours. Absolutely no fighting
or use of discriminatory language will be tolerated and will be met with immediate removal from the
camp. All campers must 18 years or older by start of camp. Furthermore, Peace Corps and Shelter +
are not responsible for any lost items, or personal injury and health issues due to negligence.
By signing, you agree to and understand all terms and conditions of Camp Republic
Signature: __________________________________
5. Written Response Question – Your acceptance in this camp will be based upon your ability to
sufficiently answer the question in English.
If you could be any one of the Greek Olympian Gods or Goddesses, WHO
would you be and WHY?
ZEUS (king of the gods and mankind, god of weather and justice), HERA (queen of the
gods, goddess of women and marriage), DEMETER (the natural goddess of agriculture
and vegetation), POSEIDON (the moody god of the seas), HESTIA (the calm goddess of
the household), DIONYSUS (the joyful god of wine and drama), APOLLO (the youthful
god of the sun and music), ARTEMIS (the wild goddess of nature and the moon),
ATHENA (the sophisticated goddess of wisdom and the arts), ARES (the fierce god of
war), HERMES (the clever god of trade and luck), APHRODITE (the sensual goddess
of love and beauty), HEPHATEUS (the disfigured god of technology), or HADES (the
gloomy god of the dead)?