UWEC - SL - Agreement Input Form

Center For Service-Learning
Pathways and Tracks Interest Form

Student Information:

First Name:		Address:
Last Name:		City:
Phone		State:
		Zip:
Username:		E-Mail address:
Times Available for meetings:	Weekday Mornings Weekday Afternoons Weekday Evenings Weekend Mornings Weekend Afternoons Weekend Evenings
Primary Interest Area:		If other:

Please press the submit button only once.

Center for Service-Learning
Human Sciences & Services 205
Ph: (715) 836-4649
Fax: (715) 836-4633
srvlearn@uwec.edu

Updated: October 4, 2007