Tell Us About Your Service

Name of Organization, Class, or Individual:

Contact Person on Campus:

Email Address:

Phone Number:

Campus Mailbox:

Name of Event or Service Project including Benefiting Organization/Cause:

Date(s) of Event:

Number of Student Participants:

Participant Names:

Total Number of Hours Spent on Project including Prep Time:

What did you do for this service activity?

What difference did it make to the organization, community, or you/your group?

What will you do next related to this organization, cause, or issue?

Money Raised (if applicable):

Please note that you will not be contacted upon receipt of this form unless
there are follow-up questions.