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Personal Information
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| First Name |
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| Last Name |
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| Email |
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| Extension |
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| CPO |
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| Wofford ID Number |
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Site # 1
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| Agency Name |
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| Have you contacted this agency? |
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| Phone |
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| Fax |
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| Supervisor |
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| Title/ Position |
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| Extension |
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| Email Address |
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| Site Street Address, City, State, and Zip |
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| Agency Website |
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Site # 2
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| Agency Name |
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| Have you contacted this agency? |
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PLEASE NOTE: You are not required to have more than one summer service site. If you have more than one, you must complete this portion. If you have more than two, please provide this information on an additional Summer Service Proposal. You can obtain one from the Coordinator.
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| Phone |
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| Fax |
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| Supervisor |
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| Title/ Position |
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| Extension |
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| Email Address |
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| Site Street Address, City, State, and Zip |
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| Agency Website |
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Additional Information
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| Have you previously participated in the Summer Service Component? If so, through what agency? What did you do? |
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| Describe what type of work you will do at your Summer Service Site(s). Be specific about your responsibilities, what you hope to gain, and how you will benefit the agency and surrounding community. |
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| What is your anticipated work schedule? |
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| Are you being paid for your Summer Service? |
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| Will you have a job outside of your Summer Service? |
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| Will you receive academic credit for your Summer Service? |
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| By submitting this form, I affirm that: |
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| I have received, read, and understand the Summer Service Guidelines |
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| If approved, I fully intend to complete the service outlined in this proposal as I have outlined it |
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| All the information I have provided is truthful and valid to the best of my knowledge |
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| I understand that if any of the information outlined herein is found to be intentionally falsified my service will be deemed invalid, and I risk dismissal from the Bonner Scholars Program |
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