Community service application form | School of Environment, Enterprise and Development (SEED)

Please complete this application form to have your proposed community service approved for the International Development minor, option, or research specialization stream.

First Name

Last Name

UW Student ID

Program

UW Email

Current term you are enrolled in

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Day time phone number

Contact person first and last name

Relationship to student

Emergency Contact's Phone Number

Emergency Contact's Email Address

Please ensure you notify this person that you have indicated that he or she is your emergency contact.

Name of Host Organization

Host Organization Country

Canada

If International, please state Country

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Host Organization Website

Contact Person & Title

Phone (inc. country code)

Contact person's email

Contact person's Skype (if applicable)

Student Assignment/Job Title

Start & End Dates (Estimated)

Total Expected No. Weeks/Hours

Job description (if available)

What is your expected role and/or key duties?

In your own words, describe the purpose and type of service this organization or initiative offers

How is this experience relevant to the INDEV mission and what you’ve learned in your INDEV courses?

What type of knowledge and/or skills do you hope to gain from this experience?

How did you find this opportunity? (i.e., through a family member or friend, INDEV suggested sites, internet search, coop/jobmine, professor, prior work experience)

International only - What is the estimated total cost of this experience – including airfare, accommodation, food and living allowance, and other fees if applicable.