Service Form

First Name *

Last Name *


I am an*

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*

Would you recommend this project to others? Why or why not.*

Information needed from Undergraduates only

(ADP only - you can provide this information or just put N/A)

How does your service meet the criteria listed in our service definition?
"Service at Warner Pacific College is defined as work that is done to the benefit of those who are within personal proximity and experiencing poverty in some way." *

How does your service experience connect with your learning at WPC?*

Explain how this activity provides a beneficial service to the community.*

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