Service Learning Tell Us More - Southwestern College

Service Learning: Tell Us More
Student Information
Name:*

First NameLast Name
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail:*
Cell Phone:*

Area CodePhone Number
Home Phone Number:

Area CodePhone Number
High School GPA:*
Potential Major (if known):
Have you made a campus visit?:*

YesNo
Would you like to visit campus?:

YesNo
What activities have you been involved with at your high school?*

Student CouncilAthletic TeamNational Honor SocietyEnvironmental ClubFellowship of Christian AthletesBible ClubService OrganizationMentoring ClubOther
What activities have you been involved with in your community?*

Not ApplicableSunday SchoolYouth GroupYouth ChoirYouth Praise TeamMission TripLeadership TeamOther
What activities have you been involved with in your community?*

Service Organization (Enter Organization name below)Big Brothers / Big SistersNoneOther
Service Organization
Please list your honors and awards:*
Briefly, what would you like to be doing after college?*
Are you interested in a particular Service Learning program (pick all that apply)?

Discipleship SouthwesternGreen Team SouthwesternLeadership Southwestern
Do you have a specific question about one of our Service Learning programs?
Should be Empty:

Service Learning: Tell Us More