Water for Life Application Form

Are you ready to learn while doing, make a difference?

You’re just two forms away from packing your binoculars, poncho, and water sampling equipment, and embarking on an adventure in Ecuador!

Please have the following materials ready before filling out the form:

  • Name, address, and email for two academic or work references
  • Statement of interest – see essay question in the form below
  • Note: for privacy and security reasons, you cannot save this form and return to it later.
  • Application Deadline: third Friday in February

 

Step 1. Ceiba Application

  • Your Contact Information

  • First Academic or Professional Reference

  • Second Academic or Professional Reference

  • Essays


    You may compose your essay in a separate file, and paste it below. Do not close this window or you will lose your previously entered responses.

    Explain why you wish to participate in this program, including which aspects most interest you, what do you wish to gain from the experience, and how might your participation contribute to the program's success? You may mention any prior experiences you would like us to consider, including your Spanish speaking ability, in evaluating your application. (500 words max.)

  • Certification and Signature


    I certify that the information I have provided in this application is true and correct and understand that my application will not be given full consideration until all required application materials are received by Ceiba. I understand that providing false information constitutes grounds for immediate expulsion from this program without refund.

    I understand that the Water for Life program to which I am applying entails physically rigorous activities and potentially stressful environments, including but not limited to: hiking in mountainous terrain and/or at high altitude, outdoor activity in extreme sun, heat and/or humidity, open water swimming, exposure to insects including bees, camping, and rustic field living conditions that lack electricity and modern sanitation. By signing below I acknowledge that I am aware of these conditions, and declare that I am sufficiently physically fit and emotionally prepared to participate in the program.

    Ceiba is a nonprofit corporation under section 501(c)(3) of the Internal Revenue code, and does not discriminate on the basis of age, sex, gender, religion, race, or ethnic origin.
  • By entering your name, you agree to the statements above.
  • MM slash DD slash YYYY
  • This field is for validation purposes and should be left unchanged.

Step Two

Please remember that applying to the Water for Life course is a two-step process.  After you have submitted the Ceiba form above, please go to the University of Wisconsin program page and click the Apply Now button to complete the UW application.  Already finished their application?  Congratulations, you’re done!

Acceptances will be sent out approximately one week after the application deadline.  Once accepted, you will receive detailed information about enrollment, and preparing for departure.  Until then, sit tight!

UW Program Page