Community Service Assessment Form

*First Name:

*Last Name:

*Student ID #:

*Email Address:

Phone Number:

- -

*Major(s):

Minor(s):

*Expected Graduation
Date:

-


	List any skills/experience you may have.

Skills:

*What type of prior
work experience
and/or community
service experience
do you have?:

(chars left: 100)

What are you
interested in and
what are your
hobbies?:

(chars left: 200)


	What amount of time do you want to commit to community service (check all that apply)?:

*Time Commitment:


	What areas are you interested in volunteering for (check all that apply)?:

*Volunteer Area
Interests:


	What type of service/setting (check all that apply)?:

Service/setting:

Is there anything
you do not want to
do as a volunteer?:

(chars left: 200)


	Others who know you well would describe you as (check all that apply):

How others describe
you:

What do you hope to
gain from getting
involved with
community service?:

(chars left: 200)

Are you willing to
participate in
training?:

Yes
No

Do you have any
special needs or
accommodation
requests?:

(chars left: 200)