First Name:
|
Last Name:
|
Email Address:
|
Program:
(MBA, MSF, MSA, PhD) |
Status:
(Full-Time, Part-Time, Special Student) |
Start date:
(Semester that you started your program ex. Fall 2004) |
Organization Name:
|
Date of Participation:
|
Brief Description of Participation:
|
Total Hours:
|
| Is this a BC Recognized Organization (Yes/No) |
| If "No," please provide the following: |
Contact Name:
|
Contact Email:
|
Contact Phone:
|
Anecdotal Feedback on Service Opportunity:
|
| How did you hear about this Service opportunity? |
| Volunteered with Organization previously |
| Employer Organized |
Other
|
