Service Learning Registration Form

Note: Late registrations will not be processed unless approved by faculty advisor!

Summer Service Learning Registration Deadline: 3 weeks before ministry start date. Registrations after that date will not be accepted unless approved by your faculty advisor.

Full Name*

First NameLast Name

E-mail*

Select the statement that best reflects your situation*

I am an on-campus student.I am an online student.

How many SL units are you registering for?*

1 SL unit - in Semester 11 SL unit - in Semester 21 SL unit - in Summer1 SL unit - for full year2 SL units with the same supervisor - 1 per semester2 SL units with the same supervisor - in Semester 12 SL units with the same supervisor - in Semester 22 SL units with the same supervisor - in Summer

Ministry Start*

Ministry End*

Name of Ministry Organization*

Name of Organization*

Please provide a brief description of what your ministry will involve.*

Full Name*

First NameLast Name

Mailing Address*

Address

Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number*

Area CodePhone Number

Supervisor E-mail*

Check Populi if you are unsure.

Faculty Advisor*

2024-2025 Fee = $166.00 / SL unit

Total

Payment

CADDescription

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Upon submission of this form the Service Learning Fee will be applied to your account.

Service Learning Registration Form

Student

Ministry Details

Ministry Supervisor

Faculty Advisor

Fees