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SOUTHWESTERN COLLEGE: SERVICE LEARNING COMMUNITY PARTNER APPLICATION FORM
This is filled out by agencies or organizations that are interested to be Service Learning Partners of Southwestern College. For any questions or clarification, please contact Jenny Davis at
jdavis5@swccd.edu
.
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Email
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Your email
Date Submitted
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MM
/
DD
/
YYYY
Agency/Organization/Company Name
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Your answer
Name of Contact Person (LastName, FirstName)
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Your answer
Position Title
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Your answer
Address (street, city, state, zip code)
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Your answer
Phone Number
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Your answer
Email Address
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Your answer
Fax Number
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Your answer
Website
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Your answer
Tax Status
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Your answer
Please provide a brief description of your organization as you would like it to appear in the directory.
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Your answer
Please list your volunteer needs:
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Your answer
Hours volunteers are needed:
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Your answer
Dates and days volunteers are needed
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Your answer
Special requirements (i.e. bilingual, TB test)
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Your answer
Please provide your COVID-19 protocol/requirement for volunteers
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Your answer
Orientation/Training requirements
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Your answer
Bus/Trolley route closest to your location
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Your answer
Please provide your Agency/Organization's Mission Statement/Goals
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Your answer
Please provide your Agency/Organization's Non-discrimination Policy
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Your answer
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