Service Learning Partnership Intake Form (For Internal DePaul Departments and Units)

Organization Name *

Mission *

Website

Address Line 1 *

Address Line 2

City *

State

Zip Code *

Country

Address Line 1 *

Address Line 2

Address Line 3

City *

State/Province/Region

Zip Code *

Country

Does your organization require its volunteers to complete a background check? *

Yes

No

If yes, please specify what type of background check and time needed for approval

First Name *

Last Name *

Title

Phone Format: (###) ###-#### *

Email Format: ex.name@domain.com *

Preferred Contact Method

Phone

Email

First Name

Last Name

Title

Phone Format: (###) ###-####

Email Format: ex.name@domain.com

Preferred Contact Method

Phone

Email

How did you hear about us?

Other

Have you already met with someone from the Steans Center? *

Yes

No

If yes, please enter their name(s)

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