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.

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* 1. What is your first name?

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* 2. What is your Last name?

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

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* 4. Place of Service

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* 5. Brief description of work.

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* 6. What was date of service?

Date

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

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

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

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

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