Student Involvement in Service Survey

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Student Involvement in Service Survey - Fall 2012

Please fill out this survey regarding the service activities you or your club/organization completed this semester (Sept 1- Dec 16). Only ONE representative from each club/organization/service learning site should fill out the information for all of the group's service activities.**

When completed, please hit submit, and then follow the instructions if you have additional service or fundraising activities to report.

**NOTE: ONLY complete this survey if you were the student leader of a service activity or if you completed individual service not associated with a group. If you were a member, please forward this to the group leader.

Name *

Please provide your name in case we have any questions about your responses.

E-mail Address

Please provide your e-mail address in case we have any questions about your responses.

Would you like to report a service activity or fundraising activity? *

(You will have an opportunity to report on both activities and submit more than one in each section, so feel free to start with either service or fundraising.)

Service Activities

Donations and Fundraising

Was your service work linked with a class?

Linked with a class (for credit)

Extra-Curricular service (not linked with a class)

Clear selection

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