CampusGroups

Alternative Break Interest Form

Contact and Student Information

Please fill out the information below so that we can contact you regarding future opportunities to engage in alternative break trips and local service experiences. Please visit our website for more information - boisestate.edu/getinvolved or reach out to Leo Mironovich at leomironovich@boisestate.edu with specific questions.

First and Last Name: *

Preferred email address and/or Boise State email address: *

Phone number: *

I am a... *

Boise State Undergraduate Student

Boise State Graduate Student

Faculty/Staff Member

Off-campus Partner

All of our service trips are issue-based and can change depending on student interests. What issue(s) are you interested in?

From our website and our Alternative Break offerings, which experiences currently interest you that you would either like to attend or learn more about? *

Anything else you would like us to know?