Student Life organizations are encouraged to submit this form after every community
service project completed during the year. Student organizations can complete a
project in the summer for early release of funds.   

Organization Name:    
Your Full Name:    
Contact Phone:    
Email:    

Our organization completed a:


  Service Project       

  Collection Drive       

  Charity Fundraiser       



Name of Benefiting Organization:    
Project Title:    
Project Date:   mm/dd/yy    
Project Description:
Include the type of service provided, benefits to the individual participants and organization:    

Complete the respective section below based on the type of service you completed.   

SERVICE PROJECT   
Number of hours spent on the project:    
Total number of students that participated in this project:    
Names of organization members who participated:    
Name of community official who can verify the project:    
Community official email:    
Community official phone:    

COLLECTION DRIVE   
Total number of items collected:    
Date items delivered:   mm/dd/yy    
Name of community official who can verify the project:    
Community official email:    
Community official phone:    

CHARITY FUNDRAISER   
Total amount raised:    
Date money delivered to charity:   mm/dd/yy    
Date receipt returned to the Office of Student Life:   mm/dd/yy    
Name of community official who can verify the project:    
Community official email:    
Community official phone: