Community-Academic Partners in Service

CAPS Interest Form

Thank you for your interest in volunteering.  The CAPS office is here to connect you to these opportunities, and with submission of this form will put you in touch with the necessary contacts to complete the application process or to answer any questions. Please note, this form does not automatically sign you up for the programs listed, instead acts as a referral.

 
First name:
Last name:
Phone number:
Email:
Address:
City:
State:
Zip:
Sign me up as a CAPS Representative, so I can receive the monthly CAPS e-newsletter and share with everyone I know.
I am:
Student Class of:
Faculty or staff Department:
Alumni Class of:
Community member or other Please Specify
School or affiliation:
If you want class credit, service-learning credit, or community service credit, what class or program are you involved in?:
Do you represent an organization interested in partnering with CAPS?
Yes No
If yes, how would you like to partner with CAPS?

Organization Name:
Organization Phone:
Organization Webpage:
How often do you wish to volunteer:
On a regular basis For a single event
Is there a particular program you are interested in:
Gender: Male Female
What is your age group:
Under 18 18-29 30-64 65+
Questions or comments:



Visit our new online store for shirts, scrubs and much more...