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The Agapé Center for Service and Learning

Fulfilling Chapel Credit through Service

Intent Form - Fall 2010


First Name:
Last Name:
Box #:
Phone #:
Student ID #:
What year are you?

Are you currently on chapel, academic, or disciplinary probation? (You may not participate if you are on probation.)

Have you participated in this program before?

If Yes, please indicate which number semester this will be for you (i.e. if this is your 3rd semester in the program, type "3").

Which site do you plan to serve at? Please see the service opportunity sheet for details. Some service opportunities may require clearances before your first visit which may decrease your eligibility to participate in this program.


NOTE: Selecting a service site below does not sign you up for that team - you must contact the appropriate Outreach Coordinator (listed below).

Companionship Ministries:

Lauren Nickell,

Messiah Village

Sustainable Agriculture:

Katie Todd,

Tutoring and Literacy:

Kara Ratliff,

Youth Mentoring:

Amie Miller,

Bethesda Youth Center
Boys & Girls Club/Salvation Army

Youth Ministries:

Quinn Dillon,

Schaffner Youth Detention Center
Please list any previous service experience with Outreach Teams and why you wish to fulfill your chapel requirement through service.


Important Information!

Enrollment will be limited to the first 50 students who apply (with an exception for Team Leaders). You will be notified via email.

Deadline is Tuesday, Sept. 7th, 2010.
Orientation chapel will be held on Thursday, September 14th, 9:45-10:30 a.m.