Community Service Summary Form
Please complete this form for EACH service project that your club/team/organization has completed this year. E-mail
or call Ann x4593 with any questions.
Group Type or Individual
Maxis-Gillet Ministry Team
Alternative Break Trip (Spring Break)
Alternative Break Trip (Summer)
Academic Class (ie UNIV 100)
Individual (not working with a group)
Name of Group/Club/Team or Individual
Group Contact Person
Contact Person Phone
Contact Person E-mail
Name of Service Activity
Date of Service Activity
Community Agency Name
What organization did you serve at? Or who benefited from your project?
Description of Service Activity
Describe what you did.
Total Number of People Who Participated in this Service Activity
Total Number of Hours Completed by All Participants
Example: If 10 people each volunteered for 2 hours, the total hours of service = 20)
How many people were SERVED?
20 kids at after-school program, 50 residents at the Senior Prom, 1 family of Habitat home, etc.
IF YOUR GROUP SPONSORED A CHARITY FUNDRAISER OR CAMPUS COLLECTION, PLEASE ALSO COMPLETE THE FOLLOWING:
Total Amount of $ or Items Collected
(45 cans of food, 100 coats, $200, etc.)
Please share a story based on this service experience. How did it impact you or other volunteers? How was your service received by the organization or people you served?
We may use your story in publicity or yearly reports on the impact of Marywood's service on our community.
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Terms of Service