2024 BUILD Profile
Please complete this form in its entirety.  This information will be used to help make BUILD the experience of your life!!!  Please return this with your completed waivers by June 30.
Email *
Name: *
Preferred name for nametag: *
Cell Phone: *
Birthdate: *
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Gender: *
Will you live on-campus in a Residence Hall? *
If yes, which Residence Hall?
Emergency Contact #1 (Name & Phone Number): *
Emergency Contact #2 (Name & Phone Number): *
Please list your insurance information (Provider, ID#, and Group #): *
Do you have any physical limitations or need any special accommodations that we should be aware of? Please explain. *
Do you have any allergies (drug interactions, bee stings, food, etc.)? Please specify. *
Do you have an Epi Pen for your allergies? If "YES" please let us know and where you keep it.
Do you have any dietary restrictions (vegetarian, low salt, no red meat, etc.)? Please specify. *
What are your favorite snack foods? *
List one little known/interesting fact about yourself. *
Where were you born? *
What is your hometown? *
How did you hear about BUILD? *
Why did you decide to participate in BUILD? *
What do you plan to major in at Georgia Southern? *
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