University of Pittsburgh BradfordAdmissions
Community Service Hours Tracking Form
    Are you reporting as an individual or on behalf of a student organization?
                

    If service was affiliated with a student organization on campus, please check the group you worked with:

     

     

     

    If other specify:  

    Your Name:

    Campus Address or Local Mailing Address: 

    Phone: 

    Email: 

    Where did you volunteer? 

    If other specify:  

    Was this a one-time service event or is the community service continuous over a span of time?   

                      

    Total Number of Volunteers:     

    Total Number of Service Hours:  

    (Note:The total number of service hours should reflect the combined amount of hours for the entire group. Example: if 5 volunteers each completed 4 hours of community service, you should report 20 total hours of service for your organization.)   

     

    Date(s) of service: 
    If you are reporting a charitable donation, please indicate the dollar amount:   

    Which organization received your donation?  

     

    Please describe your community service activity: 

     

    Documentation is required of all monetary donations. Please submit a copy of the receipt or a letter from the organization to the Office of Community Engagement.