C.W. Post Community Service Project Request

Please fill out the form below during the planning process of your project, whether it be taking place on or off campus. This form is used to assist you in working out the details, goals and items needed for your project to be most effective and rewarding to your organization. You MUST complete the full form, and receive approval from the Community Service Coordinator. (Office E Interfaith Center) All Clubs, Organizations, Fraternities and Sororities should fill this out for credit for their club status. To receive credit with Student Life someone from your club must meet with the coordinator prior to approval of project. When project is completed please fill out the Report form, also on line. Please print this page as a record for your club.

This is for:

Organization

Individual

Club, Organization or Class Name (write "none" if this is an individual report)

Name of Person making the Report (First and Last Name)

Address 1 (or Building on Campus)

Address 2 (or Room on Campus)

City

State

Postal Code

Phone

Email Address

Best Date, Day and Time for a member of our group to meet with Coordinator of Community Service.

Project Information

Name of Agency you will work with or Name of Project

Date of Project MM/DD/YYYY

Briefly Describe Your Project

Is this a direct 'person to person' project? (Will your organization be donating time and work ?)

Yes

No

How many people from your group do you anticipate in be involved?

How many hours do you anticipate will be needed to complete the project? (excluding transportation time)

How will you be transported to the project if off campus?

Is there a cost to the participant in the project? How much? (put $0 if it is free)

Is this a fundraiser for a cause?

Yes

No

How much do you hope to raise?

What are the projected costs?

What is the projected actual donation?(projected amount raised minus actual cost)

Agency Contact's First and Last Name

Street Address

Address Line 2

City

State

Zip Code

Phone Number

Email Address

Upload a copy of your flyer here:

Please add up total hours in extra projects

form:http://tinyurl.com/comserveprop

Indicates Response Required