Community Service Hours & Philanthropy Submission Form

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NOTE: Organizations completing this form only need to submit it once. If multiple members participated in the service project please indicate that in the field "Number of members participating." Please do not fill out a form for each member who was present.
Name of Individual/Organization:
Project Name:
Date Service was performed:
Number of members participating:
(Organizations only)
Hours of Service per participant:
Organization Benefitting:
Contact information for beneficiary:
(i.e. phone or email address)
Contact Person:
Brief description of project:
Amount of Money Raised:
How was the Money Raised:

Name of Person Filling out form:
E-mail of Person Filling out form:
 
Hard copies of this form can be found in the Student Life Office, 205 Slep Student Center. If you have a letter of thanks or a picture of the event please drop a copy off in the Student Life Office. Thank you for all of the hard work and making Penn State Altoona a better place!!!
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