OUTREACH SERVICE SUBMISSION FORM 2008-2009
        Links:     Outreach Main Page        Reflection/Journal Forms      

BEFORE PERFORMING OUTREACH SERVICE:

  1. See information about types of service on Outreach Main Page.

  2. Complete and  submit the OUTREACH ONLINE SERVICE FORM in the box below.
    (must submit a separate form for each DIFFERENT place of Outreach service)

  3. After submitting, you will receive a SERVICE CONFIRMATION FORM; save and print the confirmation form.

  4. Take printed  SERVICE CONFIRMATION FORM  with you to the service location on the days you give service.

  5. Follow instructions found on the SERVICE CONFIRMATION FORM for obtaining signatures and writing/submitting your reflection (go to link above for appropriate reflection/journal form).

  6. Forms normally are due within 30 days; summer service forms are due by Sept. 18, 2009.

1. STUDENT INFORMATION
Last Name               First Name             Phone   
Student I.D.              Email            
2. SERVICE TYPE
Check 1 of the following types of service and enter ALL INFORMATION in the spaces provided.
 (view definitions of service options on the Reflection/Journal Page before selecting)

    COMMUNITY SERVICE 
                   -OR-
    DIRECT SERVICE:  (Two-for-One)
Direct Service is counted only after advance approval by Sister Maryanne, who will apply the following criteria to determine approval:   Link to Reflection Journal
  • those served are poor, disabled, marginalized or sick;
  • relationship with those served occurs in a sustained, ongoing way;
  • service includes conversation and spending time in companionship;
  • student experiences "receiving" as well as "giving" in service.
3. SERVICE ORGANIZATION
  Name of organization
(required)		  
Organization Phone
(required)
Date(s) of service (mm/dd/yyyy)  
(required)
4. PRESS SUBMIT BUTTON: