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Service Interest Form
    Center for Community Service

All efforts will be made to match your interest with identified community needs. If a serious need exists that is not indicated on this form, you may be asked to consider adjusting your service to meet that need.

Please complete the form. If you have any questions, please do not hesitate to call 288-1412 or make an appointment to come in, Center for Community Service, AMU 329.

* indicates required fields

Contact Name:*
MUID#*

Mailing Address:

Address 1:  
Address 2:  
City:    State: 
Zipcode:  
Phone Number:*
Best Time to Call:
E-Mail:*
Is this for a group or you as an individual?  Group   Individual

If for a group, please complete the following:
Student Organization:
Position:
Membership Size:
Estimated # of Participants:
Mailbox in LEAD Center:

Please choose your preferences for the following:
Type of Commitment:

Other:

Preferred Dates:

Preferred Days:

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Preferred Times:
Start:     End:
Transportation:

Will provide own transportation
Needs transportation assistance

Issues:

Adult Literacy
Domestic Violence
Education/Mentoring
Environmental
Health/Mental/Disability
Museums/Cultural
Hunger/Homelessness
Community Development
Other:


What is your preference for service activities? (Examples: outdoor work, painting, social activities/visiting)
What goals do you hope to achieve through this service project?
 
   

 

Contact Office of Student Development
Click here.