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Office of Student Life Service Project Report Form

General Information

Name of Organization:  
Contact Name:  
Phone Number:  
Advisor Email:  

Service Project Information

Type of Service:    
Location of Service:    
Date of Service:    
Number of Participants:    
Number of Hours Contributed:    
Amount of Money Raised: $ 

Why was location/agency chosen (i.e. national philanthropy, related to mission, etc.)?

Contact Information for Agency

Name of Agency:            
Contact Name:            
Phone Number:            
Mailing Address:            
Website: www. 
**Contact informaiton will be used as a reference for future service options**

Organizations wishing to compete for the Community Service or Philanthropic awards given out each year during the Student Affairs Awards night must submit this form for each activity. Failure to submit the form will result in the service hours or monies raised to not be eligible in counting towards the organization’s application for the awards.