Service-Learning Application (Appalachia Service Project)
*
First Name:
*
Last Name:
*
Phone:
*
Email:
Student ID:
Academic Level:
Freshman
Sophomore
Junior
Senior
Graduate
Other
Year of Graduation
(expected):
2008
2009
2010
2011
2012
2013
2014
2015
2016
Signup for:
September 25-28, 2008 (22 left)
October 9-12, 2008 (37 left)
Prior experience or special skills (community service or construction work):
* Required
