AMSA Community Service (Fall 2018)
As you complete community service hours throughout the semester, please fill out the following form. Community service includes AMSA sponsored events, volunteer work, and community service for other organizations. For consistent community services (ex: Mercy Hospital), please input total sum of hours and specify time period in which the volunteer service was completed. If you have any questions, please email amsaucm.outreach@gmail.com
First and Last Name *
Your answer
UCM Email *
Your answer
Phone Number *
Your answer
Community Service Event *
Your answer
Company/Organization Name *
Your answer
Total Hours of Service *
Your answer
Date(s) or Period of Service *
Your answer
Supervisor Name (First and Last) *
Your answer
Supervisor Contact Information (phone number OR email) *
This information will be used for confirmation of your service, if necessary.
Your answer
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