Student Community Engagement Reporting Form
First Name *
Your answer
Last Name *
Your answer
Date of Event: *
Your answer
Location of Event *
If OTHER, where?
Your answer
Student or Staff Organization / Program / Class Involved: *
Your answer
Number of Students Participating: *
Your answer
Number of Faculty Participating: *
Your answer
Number of Staff Participating: *
Your answer
How long (in hours) did this event last? *
Your answer
Describe the Event: *
Your answer
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This form was created inside of West Virginia University - Parkersburg.