First name

Last name

Summer contact phone

E-mail Address

Address (line 1)

Address (line 2)

City

State

Zip/Postal Code

Country

Rank your interest to participate in the following trips (1 representing your first choice): (This will have no influence on whether you are randomly selected or not).

Boundary Waters Canoe Area (Mostly canoeing, some hiking)

Superior National Hiking Trail (All hiking)

**Your answers to these questions will in no way determine whether you are selected to the program or not. These will only be shared with your group leader upon your acceptance to the program. Please share honestly!

1. Why would you like to participate in the Macward Bound program?

2. What strengths will you bring to the group?

3. What may be most challenging for you?

4. Share 5 words that describe you.

The fine print: I certify that I am physically and mentally able to participate in the above outdoor recreational initiatives. If selected for Macward Bound, I am responsible for paying a $325 program fee. I understand that participants will be selected at random via a lottery. If placed in the Macward Bound program I will make a payment of $325.00 no later than July 17, 2009. I understand if placed in a Macward Bound program my payment is non-refundable if I am unable to participate for any reason.

Initials