SUMMER IN NEW ORLEANS/WORK & TRAINING CAMP

Thank you so much for your interest and dedication to helping rebuild New Orleans.

Applications for the June camp are now closed. We are now taking applications for the July camp (tentative dates of July 16-22).

You will be contacted shortly regarding your application. If you have any questions please contact Dana Balicki at Dana [@] codepinkalert.org or call her at (707)280-9074.

* First Name
* Last Name
* Email
Phone
Cell Phone
Work Phone
Home Fax
Street
* City
State
* Zip
Occupation (if retired, please state from what field)
Employer
Ethnic Background (optional)
Why do you want to go to this destination?
What do you expect to gain from participating?
Please state the ways in which your work or studies relate to the issues or
How will you share your learning experience when you return home?
Do you have any special dietary or medical needs?
Do you have any specialized skills (i.e. carpentry, electrician, therapy, etc)?
At times we are able to arrange private meetings for travelers, in addition to the general itinerary of the group. Is there a particular person or organization you would like to meet?
In order to facilitate post-tour communication, we send each member of the group a list of fellow participants’ contact information. If you do not want to be on this list, please check here
Name of person to be contacted in case of emergency:
Emergency Contact's Relation to you:
Emergency Contact's Email:
Emergency Contact's City
Emergency Contact's State:
Emergency Contact's Day Phone:
Emergency Contact's Evening Phone:
First Name
* Required Field