Published on Brock University (http://brocku.ca)

Brock Cares Day of Service Registration for individuals

Student & Community Outreach

Brock Cares Day of Service Registration for individuals

Student Participant's Information

First name: *

Last name: *

Student #: *

Area of study:

Email address: *

How did you hear about Brock Cares Day of Service? :

Student & Community Outreach website

BrockU Portal bulletin

At VolunteerFEST

Residence don

Brock staff or faculty member

Word-of-mouth among friends

Dietary Considerations

Vegetarian Meal?: *

Yes

Do you have any food allergies or special dietary needs? Details:

Accessibility Needs or Special Accommodations

Do you have any accessibility needs or special accomodations? Details:

IELP (ESL Students)

Please respond to the next question only if you are an ESL Student.

What is your current level? :

T-Shirt Size

Project Site Selection

Please select your first, second and third choices for the project sites where you would like to volunteer. More details about our project sites for Brock Cares Day of Service October 2011 can be found at ____We will do our best to accomodate your request.

1st Choice: *

2nd Choice: *

3rd Choice: *

Source URL: http://brocku.ca/student-community-outreach/brock-cares/register