Please use the following form as verification for the service hours you have completed and want credited to a class, RSO, or sanctions. This information also keeps the CSL up-to-date for benchmarking purposes. Once your hours have been submitted, the Center for Student Leadership will confirm your service completion via email.
Full Name Preferred Name Telpehone Email Address Organization Served Other Agency:
Date(s) of service (mm/dd/yyyy)
Services Performed:
Was the Service Performed with a student organization or class?
No Organization Class Discipline
Name of Organization or Class:
Please Describe your service Project:
Number of Hours Contributed:
Service Site Supervisor:Full Name Telpehone Email Address
What did you enjoy about this service experience?
What challenges and/or difficulties did you experience?
How does this service experience affect your educational or career goals?
What is your gender?
What is your ethnicity?
What is your year in school?
What is your major?
Thank you for taking part in the volunteer opportunites provided by the Wichita State University Center for Student Leadership.
