Service Learning

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Volunteer Program | Service-Learning | Student Development

Global Citizen Project

Application Form

 

* = Required Field
 
Student's First Name:* Last Name:*
Student's ID Number:*    
Street Address:*
City:* Zip Code:*
E-Mail:* Phone Number:*
Study Abroad:

Instructor's Last Name:*

5-digit course code:*
Course number and name:*
Number of hours required to complete this project is .
Project Information
Project:*  
Location:  
Student Data:
Date of Birth (Ex. 01/01/83)*

Gender

 Female Male
Units enrolled in this semester:    
Units completed to date:     
Overall g.p.a. 
Please check one: *
I plan to transfer/graduate at the end of this semester
I plan on continuing my education at College of the Canyons next semester
Expected transfer/graduation date:
Academic Major:      Career Goals:
Languages you speak other than English:
Do you have any previous service or volunteer experience? * Yes     No
If yes, how many different agencies?
If yes, (approximately) how many total hours?
List agencies you have volunteered for in the past:
 
     

 

 

 

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College of the Canyons

Valencia campus:

(661) 259-7800

• 26455 Rockwell Canyon Road, Santa Clarita, CA 91355

Canyon Country campus:

(661) 362-3800

• 17200 Sierra Highway, Santa Clarita, CA 91351


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