About Kent State Stark

IMAGE: Student Life

Community Service Summary Form

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:

About Kent State Stark

Community Service Summary Form

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