SUSI Participant Information Form

Complete this form to share important information about yourself with program staff. **This form is only for students who have been accepted to the Study of the U.S. Institute for Student Leaders on Civic Engagement (SUSI). If you have not been accepted into this program, please do not fill out this form.**


Have you been accepted to the Study of the U.S. Institute for Student Leaders on Civic Engagement? *
Please confirm that you have already been accepted by the U.S. Embassy in your home country (Angola, Botswana, Mozambique, South Africa, Zimbabwe). This form is *not* an application; it is ONLY for students who have been accepted to the SUSI program! **If you are NOT an accepted SUSI participant, please do not fill out this form.**
By what first name do you prefer to be called? This is the name that we will print on your nametag for the program.
Please indicate which THREE topics you are MOST interested in: *
On Monday, January 21, all participants will take part in volunteer projects for the Martin Luther King Jr. Day of Service. There are four different projects. Please indicate which projects you would be interested in joining. *
Please note that we may not be able to accommodate everyone's first choice. Select all projects that you are interested in (each person will be assigned to just one project, but we encourage you to indicate interest in more than one).
All SUSI participants will receive a t-shirt, sweatshirt, and rain jacket as part of the program. Please let us know what sizes you would like us to order for you.
Please note that smoking indoors is not permitted anywhere in Seattle.
Please let us know how we can best support you in terms of religious, medical, and dietary accommodations.
(For example, allergic to pollen, shellfish, peanuts, cats, dust)
Please select each of the items that you are able to eat below. *
Choose the plan that best describes you.
For example, opportunities for regular prayer.

Thank you for provided detailed information. The more we know about you, the better we can shape your program experience!