Service-Learning - Day of Service Registration Form

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Service-Learning at The Richard Stockton College of NJ

MLK Day of Service Registration

MLK Day of Service

Monday, January 18, 2010
MLK Day registration and opening activities will take place from 8-10am,
at which time all volunteers will leave for their sites. Transportation will not be provided by Stockton, except in the case of the group volunteering with the African American Heritage Museum of Southern New Jersey in Newtonville, NJ (a Stockton van driven by a staff member will transport the group to and from the site).
No community members are permitted to travel in the Stockton van with this group.
Additionally, all Stockton students and staff traveling to the AAHMSNJ are required to submit a liability waiver form prior to boarding the van – this form can be accessed on the project description page.

Registration will end on Friday, January 8, 2010, at 5pm.
All volunteers missing this deadline are welcome to register on the morning of MLK Day on a first-come, first-served basis. For descriptions of the MLK Day of Service projects (confirmed as of Nov. 19, 2009), please visit this page.

If you have any questions about the registration process,
please email Tara Ronda in the Service-Learning Office (tara.ronda@stockton.edu).

* Required Fields. Please enter valid information.

Full Name:

Z-Number:

E-mail:

Phone Number:

School Status:

Residential Status:

Project Preferences: (check all that apply)

All of these projects may not be available when you register, but we’ll do our best to accommodate you.
( Click here for more information about each project, including specific activities and skill requirements. )

	The Alcove Center		Alzheimer's Association
	Arc of Atlantic County		AtlantiCare Kids
	African American Heritage Museum		Books without Borders
	Caring Adult Medical Day (CARING Place)		Caring Adult Medical Day (Boardwalk)
	Circle K - Stockton Chapter		Covenant House
	Family Service Association		Generations Adult Day Health Care
	Samairtan Hospice		Seashore Gardens Living Center
	South Shore Ministries (Northfield)		South Shore Ministries (Pleasantville)
	The Shores Wesley Manor		No Preference

If you are a Stockton faculty or staff member, are you willing to serve as a project leader? (Project leaders should be willing to ride the bus/van to and from the site with their team, supervise students, and help students reflect on the experience as they are volunteering.)
Yes No Maybe

Special Needs or Accommodations:

Other comments: