Champions of Change Reporting Form

1
Sport* This field is required.
Choose one
Choose one
Baseball
Basketball (Men's)
Basketball (Women's)
Esports
Golf
Soccer (Men's)
Soccer (Women's)
Softball
Staff
Volleyball (Women's)
2
Are you a staff member or head coach?* This field is required.
Please select one
Please select one
Staff Member
Head Coach
3
Name* This field is required.
First Name
Last Name
4
Email* This field is required.
example@example.com
5
Name of Activity* This field is required.
6
Date of Activity* This field is required.
Date
Month
Day
Year
7
Description of Activity* This field is required.
Huge
Large
Normal
Small
Ok
Ok
8
Partnering Department or Organization Nameie. Madison College Volunteer center, Madison College Student Life, Goodman Community Center, Red Cross, etc.
9
Partnering Department or Organization Email* This field is required.
example@example.com
10
Number of Hours* This field is required.
11
Number of Participants* This field is required.
12
Indicate Participants* This field is required.
Choose Option
Choose Option
Manually enter participants
Attach file with a list of participants
13
Enter Participants* This field is required.Include Full Names and Student-ID numbers. Also, indicate one participant per line.
14
Upload Participant FileAttach a file that indicates participants including their full names and student-IDs
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
15
Please verify that you are human* This field is required.
Should be Empty: