Student's First Name*
Student's Last Name*
Date You Performed Service*
If your service was over a period of time, please list the dates of the service performed.
Number of Hours Performed*
If the total hours are over 10 hours, please see Mr. Hampel in the Campus Ministry Office.
Name of Organization/ Individual Provided Service For*
Please describe what type of Christian Service you provided.
Type of Christian Service Hours*
Red- economically poor, physically handicapped, disadvantaged member of society, verifiable need of a marginalized family, elderly
White- any church, school, non-for-profit business
Supervisor's Full Name*
Please send a confirmation email to the address below*: