Student Profile Sheet/student Registration Form printable pdf download

Student Profile Sheet/student Registration Form

Student Profile Sheet

Student Registration Form

Please print and complete in blue ink:

______________________________________, _________________________________, ___________

Last

First

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:______________________________

Student Profile Sheet/student Registration Form