About Kent State Stark

Community Service Summary Form

Student Life organizations are encouraged to submit this form after every community
service project completed during the year. Student organizations can complete a
project in the summer for early release of funds.

Organization Name:

Your Full Name:

Contact Phone:

Email:

Our organization completed a:

Service Project

Collection Drive

Charity Fundraiser

Name of Benefiting Organization:

Project Title:

Project Date:

mm/dd/yy

Project Description:
Include the type of service provided, benefits to the individual participants and organization:

Complete the respective section below based on the type of service you completed.

SERVICE PROJECT

Number of hours spent on the project:

Total number of students that participated in this project:

Names of organization members who participated:

Name of community official who can verify the project:

Community official email:

Community official phone:

COLLECTION DRIVE

Total number of items collected:

Date items delivered:

mm/dd/yy

Name of community official who can verify the project:

Community official email:

Community official phone:

CHARITY FUNDRAISER

Total amount raised:

Date money delivered to charity:

mm/dd/yy

Date receipt returned to the Office of Student Life:

mm/dd/yy

Name of community official who can verify the project:

Community official email:

Community official phone:

About Kent State Stark

Community Service Summary Form

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