First Name *
Last Name *
I am an*
Undergrad studentAdult Degree Program student
Student ID (for undergrad students only)
Date of service project:*
Number of hours served*
In one to two sentences, please describe what kind of service you participated in. (30 words or less)*
Was this service project directly connected to a class assignment? (This will not affect your ability to receive credit.)*
If so, what is the course number?
What is the professor’s name for this course?
Name of service organization*
Organization's contact person*
Contact person's phone number*
Which Service Track did this service address*
Economic EquityGender EquityYouth & Child SupportSupport for the Disabled & ElderlyRacial & Ethnic EquityEcological JusticeInterfaith Relationship
Would you recommend this project to others? Why or why not.*
(ADP only - you can provide this information or just put N/A)
How does your service address a tangible need directly related to one of Warner Pacific’s seven service categories: Economic Equity, Gender Equity, Racial/Ethnic Equity, Youth & Child Support, Support for the Elderly & Disabled, Ecological Justice, and Interfaith Relationship *
How does your service experience connect with your learning at WPC?*
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