Student Volunteer Registration Form
1801 Fayetteville St. Durham NC 27707
NOTE: All NCCU students who fall under the graduation
requirement must register for service by filling out this form. Students
should select a service opportunity from the ACSLP
Agency Book or the
One-Time Events and enter the information at the bottom of the
form. It is then the responsibility of each student to contact the
community agency to work out details of performing their service.
NCCU provides transportation Monday through Friday within three miles
Local Phone Number:
Cellular Phone Number:
Local Mailing Address:
***Your NCCU e-mail address is required.
***E-mail addresses collected through NCCU
forms are used for statistical and security purposes only.
Choose from NCCU's ACSLP
One-Time Events or from the ACSLP
Agency Book Note: These are PDF files requiring the popular, free
Adobe Acrobat Reader.
Agency ID or OTE ID Number:
Agency Phone Number:
Type of Service:
Please Select One
Please Select (Optional)
Time to Read
Esteria Woods Int'l
Service-Learning: Course No.
Will need Transportation?