Welcome to the Staff and Faculty Community Benefit Reporting tool.  In order to measure the impact the College's staff and faculty have on our community it is vital that you fill out this form each time you serve the community outside the College. This includes any time or donations you spend on behalf of the College (ie. reading to school children during work hours for Read Aloud Day) or as a volunteer for personally important causes (ie. volunteering at your place of worship or charity of your choice). Although the positive impact of our efforts to benefit our community are often difficult to measure, please answer the questions below to the best of your ability.  Thanks for making a difference! 

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* 1. Please enter your name (optional).

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* 2. Department:

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* 3. Enter the date of service.

Begin Date
End Date

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* 4. Did you volunteer during work hours or on personal time?

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* 5. Did you volunteer for a personal cause or a cause promoted by the College/Medical Center?

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* 6. Enter the number of hours you volunteered on the date(s) entered in question 3.

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* 7. Enter the name of the program and/or organization and briefly describe your activities.

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* 8. Enter the name of the sponsoring department, if applicable.

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* 9. Who was your target audience? (School children, cancer patients, underserved/economically disadvantaged...)

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* 10. Where did you volunteer?

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* 11. Estimated number of people served.

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* 12. Estimated cost incurred (if known). This would include the cost of supplies required for the event.

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* 13. Estimated revenue generated by the event (if known) or the amount of your personal donation.

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* 14. Funding for this event.

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* 15. Name of contact person if applicable.

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* 16. Phone number of contact person, if applicable.

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* 17. Email address of contact person, if applicable.

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* 18. List any community partners.

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* 19. Comments:

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