Application Form
Schuylkill Acts & Impacts is a 6-day watershed expedition along the 120-miles of the Schuylkill River, from its headwaters in the anthracite coal lands of Schuylkill County to its confluence with the Delaware River in Philadelphia. Twelve select students from all 5 counties in the watershed come together to experience first-hand the impact of land use on water quality through guided tours, fieldwork, water sampling and interactive presentations with policy makers and planners. Students camp out each night and need to bring a sleeping bag, but all other necessary gear, food and transportation including tents, kayaks, and life jackets will be provided. For more information, visit https://fairmountwaterworks.org/programs/summer/acts-and-impacts/

Students must be high school age and live or attend school in Schuylkill, Berks, Chester, Montgomery or Philadelphia counties. Selected students must participate in the entire program from Sunday, July 31, 2022 to Friday, August 5, 2022.

Applications are due by 4:00 pm on Friday March 25, 2022
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Student Name *
First and last name
Student Email *
Student Phone number
Date of Birth: *
Gender: *
Student Address *
County: *
School District and School name: *
Current Year in School: *
Why would you like to participate in the Schuylkill Acts & Impacts program, and what can you contribute (special skills, knowledge, etc.) to the expedition? *
Have you ever spent time volunteering or doing service work? Briefly describe your experience and what you learned from it. If you have not done service work, why are you motivated to do so now? *
We will utilize reflection (i.e., discussions, journaling) throughout the Schuylkill Acts & Impacts program. What importance do you think reflection has in a program such as this? *
How did you learn/hear about the Schuylkill Acts & Impacts program? *
Parent/Guardian Name *
Parent/Guardian Email: *
Parent/Guardian Cell Phone: *
Parent/Guardian Address: *
Upon selection, parent/guardian will be required to complete and sign all medical forms, waivers, and consent forms in order for student to attend.                        A teacher familiar with the applicant must email (outreach@schuylkillheadwaters.org ) a recommendation discussing student's commitment to learning and any interests/involvement in environmental studies or service projects. Teacher recommendation must be received by Friday April 1, 2022. *
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