Credit Request Form

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Credit Request Form

If you have the opportunity to participate in a service event not publicized by the NHS Board, you may use this form to inform the board of the event BEFORE it takes place. To clarify, the board will NOT retroactively award credits; rather, it will either accept or deny credit before the event. The member must notify the board via this form at least ONE WEEK before the event takes place, and the member will receive an email with the board's decision and the number of credits awarded. Thank you!

Full name *

Event name *

Event date *

YYYY

Event start time *

Time

Event end time *

Time

Event description *

Event coordinator *

Event coordinator contact (email and/or phone) *

Is this event recurring or isolated *

recurring (occurs regularly)

isolated (only occurs once)

Does this event need any more volunteers? *

Submit

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