Office of Student Conduct Community Service Site Submission Form
Please visit http://www.pacificu.edu/about-us/offices/student-conduct/conduct-process/sanctioning to be sure your site meets the required criteria. If you are assigned community service as a sanction, it is your responsibility to find an appropriate community service provider and submit your site for approval via this form. This form AND an approval confirmation from the Office of Student Conduct is needed prior to performing any service. Service that is completed without or prior to approval may not be accepted.

If you have questions please contact studentconduct@pacificu.edu.

Your full name *
Your answer
Your Pacific University email *
Your answer
Total hours of community service you've been sanctioned to complete *
Your answer
Service organization Name *
Your answer
Service organization website URL (if none exists type N/A) *
Your answer
Service site point of contact name (i.e. name of site supervisor, organization secretary etc.). If signed up through Hands on Portland and none listed, state that here. *
Your answer
Phone number and/or email of service site point of contact. *
Your answer
Proposed date(s) and time interval(s) of service (i.e. Friday July 22, 2016 1-4pm and Saturday July 23, 2016 3-5pm) *
Your answer
Total number of hours you plan to work at this site *
Your answer
Submit
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