Alternative Break Registration Form

Last Name *

First Name *

Sacramento State Affiliation *

If you are a student, please provide your Student ID number

If you are a student, what year are you?

Major

Email address *

Phone number (best number to reach you) *

Emergency Contact Name *

Emergency Contact Phone Number *

If you graduated from Sac State, please enter the year you graduated:

Are you participating in the SO&L Leadership Initiative? *

Yes

No

Please select your Sac State Volunteers Shirt Size *

Have you participated in past volunteer events with Community Engagement Center? *

Yes

No

If you selected yes, please check all that apply. *

Paint the Town 2016

River City Food Bank 2016

Harvest Sacramento 2017

Please select the day(s) and shift(s) you will volunteer *

Volunteers will be working on campus sustainability projects such as planting gardens, mulching, litter pick-ups around the arboretum, working on rain gardens, and beautifying the American River trail. Please select which date(s) you would like to volunteer for.

(FULL - Do not Select) Campus Sustainability Project; Monday 8:30am-12:30pm (FULL)

Campus Sustainability Project; Tuesday 12:30pm-4:30pm

Keep the American River Beautiful; Wednesday 12:30pm-4:30pm

Keep the American River Beautiful; Thursday 8:30am-12:30pm

Age 18 or over? *

Yes

No