Registration Form

Celebrate Service Day

	*Name of Organization
	*Contact Person Name
	*Contact Person Job Title
	*Phone
	*Email Address
	*Physical Address
	*City
	*State
	*Zip
	Mailing Address (if different from Physical Address)
	Mailing Address City
	Mailing Address State
	Mail Address Zip
	Host	Yes, we want to host a group of student volunteers and their faculty/staff leader. We will provide four to six hours of steady work for:
	Number of students	8-15 students 16-25 students
	Refreshment/Lunch	We are willing to provide refreshments for an afternoon break We are willing to provide lunch for the volunteers
	Please briefly describe the task that you envision the volunteers doing during the day

Goshen College 1700 South Main Street, Goshen, Indiana 46526
Toll free: 1 (800) 348-7422 • Local: (574) 535-7000 • E-mail: info@goshen.edu

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