RH Volunteer Interest Profile

Community Service Program (CSP)

Rose Hill Volunteer Interest Profile

:: CONTACT INFORMATION ::

First Name:	Last Name:
Year of Graduation: Freshman (2012) Sophomore (2011) Junior (2010) Senior (2009) Major / Minor:
Gender: Male Female Other
Hometown:
Local Address (Street, City, Zip) or Mailbox # (PO Box #)
Telephone# (cell):	Email:

:: COMMUNITY ENGAGEMENT PLACEMENT ::

Please check 3 areas of interest: (For a description of each, click here)

Adult Education Community Development Community Organizing Criminal Justice Elderly	Environmental HIV/AIDS Health/Hospital Hunger/Soup Kitchen Housing/Shelter Outreach	Immigrant/Refugee Mentoring Special Needs Youth Tutoring Women's Issues
Other:

Availability to Volunteer(i.e. Mondays 3-6pm)

Do you have any previous experience with the local community?
If so, in what capacity? What organization?

:: ADDITIONAL INFORMATION ::

How did you hear about the Community Service Program?

Word of Mouth
Brochure
Website
Flyer on campus
Announcement in Class
Other (Please specify)

Would you like to receive CSP announcements, including a monthly newsletter, internship/job opportunities and cultural events?

Yes
No

Thank you for your time. We will contact you shortly.

Edited by: The Webgroup