Community Service Form
Student Name
*
First Name
Last Name
Student Email
*
example@mail.fresnostate.edu
Grade Level
*
Please Select
9
10
11
12
Organization Name
*
Year of Service
*
Input the year of your service.
Semester of Service
*
Please Select
Fall
Spring
Summer
Total Hours of Service
*
Service Description
*If you worked for Zooniverse please convert your classifications/total hours in this box.
Organization Supervisor Name
*
First Name
Last Name
Organization Supervisor Email
*
example@example.com
Volunteer hours will be verified by UHS staff
An email receipt will been sent so keep track of these receipts in an email file as proof of service hours.
Submit
Should be Empty: