2018-2019 Service Hour Reporting Form
Use this form to submit any service hours that are required by your service based scholarship. If you have any questions, please contact Academic Affairs, (316)942-4291 ext. 2308 or hamiltona@newmanu.edu.

Service Deadline dates are: December 17, 2018 and May 17, 2019

Last Name *
Your answer
First Name *
Your answer
Type of Scholarship *
Class Rank *
Non-Profit (501(c)3) Organization/Office/Project where service was given: (example: Habitat for Humanity) *
Your answer
Date(s) *
Your answer
Hours of service per date *
Your answer
Type of work completed (be specific): *
Your answer
Contact Supervisor and phone #: *
Your answer
Submit
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