Real World Geneseo Form 2021
This information form will be treated confidentially and will help the facilitators understand more about our Real World Geneseo community.
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First Name *
Last Name *
Email Address *
Date of Birth *
Your response should be formatted MM/DD/YYYY
Gender Identity *
Race/Ethnicity *
Required
Sexual Orientation (if you're comfortable)
Religion/Faith
Political Ideology *
Please answer in one or two sentences
Socio-Economic Status
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 or other number of contact *
Emergency Contact 1 *
Emergency Contact 1 Phone Number *
Emergency Contact 2
Emergency Contact 2 Phone Number
I commit to attending every part of the Real World Geneseo retreat, January 28-31, 2020 . 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. *
Required
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