Fall 2021 RMI 3682 Community Service Form

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In order to receive credit for RMI3682, a community service event must be completed.

Please fill out this form and describe your act of service in order to satisfy your credit.

Email *

Name ( First, Last) *

Temple Email *

Student ID Number *

Major *

Graduation date *

YYYY

Date of Service *

YYYY

Please select the option that best describes your act of service *

Tutoring at no cost

Free music lessons to schoolchildren

Babysit children at no cost

Donate clothes to shelter

Pick up medication / run errands for elderly

Rake leaves, shovel snow, or wash windows for a senior citizen at no cost

Deliver treat to a homebound senior citizen

Clean up a local park

Plant native flowers or plants along highways

Volunteer at a soup kitchen

Clean up a vacant lot

Send a package or cards to deployed troops

Collect children’s books and other reading materials for shelters

Donate non-perishables to local food bank

Neighbor clean ups ( Clean up YOUR own street)

Write a letter to an elder in isolation due to COVID-19 (https://www.eastsideelders.org/letters-to-elders/)

Other

If you selected other, please explain here

Please provide details here of your act selected above (What exactly did you do) *

Please provide contact information (Be as specific as possible) We want to know who you volunteered for, where and why *

I acknowledge that the above information is filled out correctly to the best of my ability, and that falsifying any of the above information is considered a violation of the university's academic honesty policy and is subject to appropriate punishment *

Yes, I have

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