Community Service Hours--Group Submission

Please complete this form for hours in any group service project.  Form to be completed by coordinator/supervisor of project.

* 1. What is your first name?

* 2. What is your Last name?

* 3. Status of Those involved in this Project.  Check as many as apply.

* 4. Place of Service

* 5. Brief description of work.

* 6. What was date of service?


* 7. Number of people associated with Brescia University involved in this service project.

* 8. How much time (in hours) did you spend in service? (.5, 1.5, 2, 3.75, etc)

* 9. Total number of Hours in Service.  (#of participants X #of hours)

* 10. If applicable, indicate Club, Organization, Sports Team, Class, etc with whom you were performing service.