Student Profile Sheet/student Registration Form

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Student Profile Sheet
Student Registration Form
Please print and complete in blue ink:
______________________________________, _________________________________, ___________
Last
First
MI
Address: ____________________________________________________________________________
City: ____________________________________ State: ____________________ Zip: ______________
Contact Number: _____________________________________ Date of Birth:_____________________
Student ID Number: ___________________________________ Major: _________________________
E-mail Address: ______________________________________Personal Transportation: ___________
Yes or No
Classification: _______Freshman _______ Sophomore _______ Junior _______ Senior
Volunteer area of interest: __________________________________
Special Skills: _________________________________________________________________________
Have you participated in volunteer service in the past? _____________
Yes or No
If so, when and where? ________________________________________________________________
Available times: _______________________________________________________________________
(May Submit class and work schedules)
____________________________________________________________________________________
For Office Use Only
Assigned Site: ________________________________ Site Supervisor: ___________________________
Background Check (if required): ________________________ Number of hours completed: _________
Date hours completed: _________ Community Official Signature:______________________________

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