Community Service Site Pre-Approval Form
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First Name *
Last Name *
NetID *
Graduation Year (ex. M2027) *
Community Service Site *
Address *
Site Contact Name *
Phone number *
Email address *
Community service site contact name, email, and phone for SOM Website (if different from above)
Please describe the duties you would be performing in detail ( in 75- 150 words).  *
What date(s) would you be performing these duties (please indicate "ongoing" if there is not a defined date)? *
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