California State University, East Bay Signature Mark

Freshmen Day of Service Project

Spring 2020

    Mission
    *
    Community Partner
    All Fields Required

    ( Example: Microsoft, etc.)
    ( NOTE: Leave AS IS if No Web Site )
    ( Please enter the full URL (link) of your website, including http://, https://, etc.
    Example: [ CORRECT ] https://www.google.com/ - [ INCORRECT ] google.com     )
    Community Partner - Contact
    * Required
    *
    *
    *
    *
    ( Please double check. Your confirmation email and all future correspondences will be sent to this address.)
    *
    (Mobile Phone Preferred)
    Project Category / Type / Population & Safety Information
    PROJECT CATEGORY
    (Check all that apply) * Minimum 1 Selection Required
    Economic Opportunity

    Education

    Environment




    Health


    Other

    PROJECT TYPE
    (Check all that apply) * Minimum 1 Selection Required



    WHAT POPULATION WILL OUR STUDENTS BE SERVING?
    (Check all that apply) * Minimum 1 Selection Required







    SAFETY INFORMATION
    Potential Risks or Risk Exposure:
    (Check all that apply)
    * Minimum 1 Selection Required









    Availability of bathrooms for students: *
    Emergency Plan/Protocol for Student Leads: *
    Project 1 Information
    * Required
    & *
    *
    Project Location: *
    State: CA
    Project Supervisor(s):
    * Minimum 1 Supervisor Required
    *
    *
    *

    Project Start- and End Time: *
    ( NOTE: Projects must be 3-4 hours in length; 8-hours projects can be split into two shifts. In order to ensure an equitable experience for students, shorter projects cannot be accepted.)
    Start Time:
    End Time:
    *
    Are you able to accommodate "Drop-In" student
    volunteers (Not on the registration roster)?     *
    Mandatory Web Site Registration: *
    Additional documents (waiver, etc.) required? *
    Bilingual Volunteers: *
    Student Photo Release: *
    Public Restrooms: *
    Transportation Access: *
    ( Check all that apply)
    * Minimum 1 Selection Required     		PERSONAL:



    PUBLIC:





    [SFMTA: The San Francisco Municipal Transportation Agency]





    OTHER:
    *
    (Water, Snack, Sunscreen, etc.)
    Meal(s)/Snack(s) Provided: *
    (Check all that apply)
    * Minimum 1 Selection Required




    *
    (Protective clothing, Closed toe shoes, etc.)

    ( SEE STATEMENT BELOW )
    eSignature
    Required
    Please read the following Bad Weather & Cancellation Protocol statement carefully, then acknowledge that you have read and approved it by providing the information requested at the bottom of the page. Please note that an esignature is the electronic equivalent of a hand-written signature.
    BAD WEATHER & CANCELLATION PROTOCOL:

    By completing the information below, I acknowledge that if a project needs to be cancelled due to heavy downpour or unforeseen circumstances, a site supervisor will contact the CCE via email or phone by Friday at 4:00 PM prior to the project. In the event of a last minute cancellation, a site supervisor will be present at the site to notify students that the project is cancelled and will immediately notify the CCE by calling the emergency phone number.

    Do Not E-sign Until You Have Read The Above Statement.

    By signing this form, I acknowledge that all the information provided in this form is accurate to the best of my knowledge, and I certify that I have read, fully understand and accept all terms of the foregoing statement.
    Please signify your acceptance by entering the information requested.



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