SVS Service Learning Request Form
Date of Request:
MM
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DD
/
YYYY
Person making request:
Person making request:
Name of Organization
Date(s) of Activity or Event
MM
/
DD
/
YYYY
Rain Date(s)
MM
/
DD
/
YYYY
Time(s) students are needed to work
Location of Activity or Event
Location of Activity(s) or Event(s)
Description of activities:
Number of students needed:
Name of Contact Person:
Contact Telephone:
Contact Email:
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