Community Service Form

Marywood University - Office of Campus Ministry

Community Service Form

Many Marywood students participate in community service. We are proud of all that you do for the community, and are trying to gather data about community service completed during this academic year. Please help us by taking a few minutes to answer the following questions. Thank you in advance for your response, and more importantly, thank you for your service!

Frist Name* :
Last Name* :
Email Address* :
Academic year* :

* - denotes required fields.

Academic Service-Learning

Have you participated in academic service-learning, i.e., service that was a class requirement?


	If yes, what course?
	Number of service hours:
	Briefly describe what you did and how your service benefitted the community:

If you participated in more than one service-learning course during the academic year, please complete the same information for each course.


	If yes, what course?
	Number of service hours:
	Briefly describe what you did and how your service benefitted the community:


	If yes, what course?
	Number of service hours:
	Briefly describe what you did and how your service benefitted the community:


	If yes, what course?
	Number of service hours:
	Briefly describe what you did and how your service benefitted the community:

Co-curricular Service Learning

Have you participated in co-curricular service learning, i.e., service that was not part of a class, but included some kind of reflection, e.g., a service trip, Maxis-Gillet, etc.?


	If yes, what type of service?
	Number of service hours:
	Briefly describe what you did and how your service benefitted the community:

If you participated in more than one co-curriculum service learning activity during the academic year, please complete the same information for each course.


	If yes, what type of service?
	Number of service hours:
	Briefly describe what you did and how your service benefitted the community:


	If yes, what type of service?
	Number of service hours:
	Briefly describe what you did and how your service benefitted the community:


	If yes, what type of service?
	Number of service hours:
	Briefly describe what you did and how your service benefitted the community:

Any Other Kind of Community Service

Have you participated in any other kind of community service, i.e., visiting a nursing home, working at a soup kitchen, fundraising, etc.?


	If yes, please list each activity, the number of service hours for each, and a brief statement describing how your service benefitted the community.
	#	Type of Activity	Service Hours
	1.
	2.
	3.
	4.
	5.

Campus Ministry | Swartz Center for Spiritual Life | campusministry@marywood.edu | (570) 961-4723