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Service Day

Community Partner Project Registration Form

Service Day will be Thursday, April 14, 2011 (rain date is Tuesday, April 21).

If you have not reviewed the project guidelines, please do so here before registering your project.

Please note: pressing the "enter" key at any point in this form will automatically submit the form. To navigate between fields, please use the "tab" key or by clicking your mouse.

Deadline for Project Registration is Friday, March 4, 2011

Questions? Email ServiceDay@messiah.edu

Community Partner Organization:
Description of Organization: (mission/values/clients, etc.)
Contact Person:
Contact Position:
Address:
City:
State
Postal Code:
Location Address: (if different from mailing address)
Desk Phone:
Cell phone number:
Email:
Website:
Primary Project Activities and Goals
Project Team Leader Name (if known)
Project Leader email address: (if known)
Project Leader Phone / Ext. (if known)
Cell phone number:
How many people can participate?	(maximum) *Please enter a number
	(minimum) *Please enter a number
Project Start Time:
Project End Time:
Are you able to host students on the rain date, April 21?	Yes No
Clothing Requirements:
Is your facility handicap accessible, and would students with disabilities be able to participate?
Are you able to provide lunch for the group of volunteers coming?	Yes No The team won't be serving over the lunch hour
Please indicate any specific parking or driving instructions for your team to meet you on site that day. Also the name and cell # of the site superivsor meeting the team that day, if different from above.
Additional Comments and Suggestions: