Registration 1/5/16, 1:26 PM Ritt Kellogg Memorial Fund Registration Registration No. T92J-YWKQT Submitted Jan 4, 2016 2:20pm by Margaret Bursch Registration Sep 1, 2015- Ritt Kellogg Memorial Fund Waiting Aug 31 RKMF Expedition Grant 2015/2016/INDIVIDUAL for This is the individual application for a RKMF Expedition Grant. If your group has received approval, you may Approval fill out this application individually. In this application you will be asked to provide important details concerning your experience and eligibility for your proposed expedition. Sep 1, 2015- Ritt Kellogg Memorial Fund Waiting for Aug 31 RKMF Expedition Grant 2015/2016/Group Application Approval This is the group application for a RKMF Expedition Grant. In this application you will be asked to provide important details concerning your expedition. Participant Margaret Bursch Colorado College Student Planned Graduation: Block 4 2016 CC ID Number: 120674
[email protected] [email protected] (907) 299-4209 (Cell/Text) 2233 mt. augustine dr. homer, Alaska 99603 Date of Birth: Sep 1, 1993 Emergency Contacts tom bursch (Father) (907) 235-5111 Medical History 1. Dizzy spells, fainting, convulsions, or persistent headaches Other medical, physical, behavioral, or other conditions of which our program should be made aware 2. I occasionally have moderate back and knee pain. This are due to a past injury and can be reduced through stretching and rest. Medical Details: I experience dizziness or fainting if I experience extreme pain. I also have lower back pain. I have gone to the doctor regarding both of these. https://apps.ideal-logic.com/worker/report/28CD7-DX6C/H9P3-DFPWP_d9376ed23a3a456e/p26fa6b14/abf739e91ed89/registration.html Page 1 of 23 Registration 1/5/16, 1:26 PM by various size and demographic of groups on backpacking, paddling, skiing, biking and climbing multi day and single day trips.