iE Student Volunteer Verification Form
Please complete this form to verify that the iE student below volunteered for you/your organization.
Student name
*
First Name
Last Name
Student ID Number
*
Student email address (for successful submission confirmation)
*
You will receive an email confirmation within a few minutes that this form has been submitted successfully.
Volunteer service date
*
-
Month
-
Day
Year
Date
Organization/group/person student is volunteering for:
*
Location
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Description of volunteer services:
*
Total Number of Hours Volunteered:
*
Name of volunteer supervisor
*
First Name
Last Name
Supervisor phone number
*
Please enter a valid phone number.
Supervisor email
*
example@example.com
Signature of organization representative or person student volunteered for:
*
Submit
Should be Empty: