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Unformatted text preview: Leaders In Service Print Form Be a Leader, Serve Volunteer Application
This application must be printed and delivered to the Indian Quad Information Center.
Name: Adriana Carozza Date September 1, 2011 02/24/92 Date of Birth:
Campus Address: Colonial Quad/ Johnson Hall 304-2 Quad/Res Hall
Home Phone # Room 9143296489 Email Address 1705
Box# email@example.com Classification: Cell Phone # Frosh Sophomore Junior 9143296489 Senior Graduation Date: 2014 Medical Concerns:
(Example: Asthma) Emergency Contact Information:
Name: Michelle Carozza
Address: Phone Number: 119
Street # Relationship: Edgewood Avenue 9144196731 Thornwood NY 10594 City State Zip Street Name Mother Volunteer Interest: (Please Check)
Drug & Alcohol Rehabilitation
Home Building Other What special gifts/talents do you have, that might be of
benefit to the greater Albany community?
How many hours each week are you able to devote to community service? 50-60
During what hours are you available to complete community service?
Monday 2pm - 11pm Friday 2pm - 11pm Tuesday 12pm - 3pm, 6pm - 11pm Saturday 8am - 12am Wednesday 2pm - 6pm Sunday 8am - 11pm Thursday 12pm - 3pm Are you interested in participating in community service beyond the current semester?
Yes Please list
activities: No I have volunteered as a camp counselor for my town's camp, where I worked with third graders. I have also volunteered
at Make A Wish Foundation's bake sales at my local elementary school. I was a peer mentor to the underclassmen of my
former high school. I joined my school's Habitat for Humanity chapter, where we rebuilt an elderly couple's house, and
raised money for Haiti. Essay: Please describe the role community service plays in your life. If you are not currently
involved in community service, please describe the role that you would like community
service to play in your life. At the present time, community service does not play an active part of my life. Although I am not currently involved in community
service, I have completed a variety of volunteer activities in the past. I enjoy helping others and take pride in the fact that I can make a
difference. 'Leaders in Service' is something that I would do for more than just course credit. I volunteer so I can give back to what has
been given to me. ...
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- Spring '11