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Alternative Break Application
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Alternative Break Application
*Items in bold with an asterisk are required.
First Name:
Middle Initial:
Last Name:
Email Address:
Subscribe to AFSCME E-Update
Address:
Address2:
City:
State:
- Please Select -
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip:
(xxxxx-xxxx)
Phone:
(xxx-xxx-xxxx)
Alternative Phone:
(xxx-xxx-xxxx)
Is anyone in your family an AFSCME member?
Yes
No
Not Sure
1. Which session would you like to attend?
- Please Select -
Session 1 (March 15-20)
Session 2 (March 22-27)
2. How did you find out about this opportunity?
- Please Select -
Online Job Posting
Professor
On Campus
Social Justice Organization
AFSCME Recruiter
Referral
Classroom Presentation
Job Fair
AFSCME Member
Other
Please specify in more detail how you found out about us
3. What college or university do you attend?
4. What is your major?
5. What is your expected graduation date?
...
6. What are you hoping to get out of AFSCME's Alternative Break and how does it fit with your career goals?
7. Union organizing is a social justice movement. What social justice issues are you most concerned about and how have you acted on those concerns?
8. This program is for students who are seriously considering a career in the labor movement. Why do you want to be a union organizer?
9. Describe any community, political, union or student organizing or social activist groups that you have volunteered or worked with. What was your role?
10. AFSCME's Alternative Break program will be an intense week with long and irregular hours working with a diverse group of students. Have you ever gone through such an experience? If yes, please explain.
Yes
No
11. Please list two references, title, organization and relationship to you. Include contact information.
12. In addition to English, what other languages do you speak fluently?
13. Do you have a driver's license?
Yes
No
14. Please upload your résumé here:
(Résumé must be less than 1MB and be of file type .pdf, .doc, .docx, or .txt)
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