Real World Geneseo Form 2022
This information form will be treated confidentially and will help the facilitators understand more about our Real World Geneseo community. Learn more at https://www.geneseo.edu/multicultural/rwg

This year's RWG Retreat will be held virtually.
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First Name *
Last Name *
Geneseo Email *
Date of Birth *
Your response should be formatted MM/DD/YYYY
MM
/
DD
/
YYYY
Gender *
Race *
Sexual Orientation
Clear selection
Religious Tradition
Political Ideology, please describe *
Socioeconomic Status, please describe
Do you have any dietary restrictions? If so, what are they? *
Major at SUNY Geneseo *
Number of semesters at SUNY Geneseo *
Place of Birth
Where did you grow up?
What languages do you speak?
Describe your college experience? *
Response should be no more than 250 words.
Extracurricular Activities, Hobbies, Interests   *
List involvement in school, work or community service activities:
Leadership Involvement *
What current/past leadership opportunities have you had?
How did you learn of Real World Geneseo? *
Describe what impact you would like for RWG to have on your personal, academic and future development? *
Personal Attributes (List two things about yourself that people would be surprised to know) *
Cell Phone Number *
Emergency Contact 1 Name *
Emergency Contact 1 Phone Number *
Emergency Contact 2 Name
Emergency Contact 2 Phone Number
I commit to attending every part of the Real World Geneseo retreat, January 20-23, 2022 as well as the weekly class during the spring semester on Thursdays from 4:00 to 4:50. Also, in the case of emergency while I am attending the retreat, you may contact either or both of the two people I have designated as emergency contacts. *
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