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ACSLP Online Agency Registration
1801 Fayetteville St. Durham NC 27707
919-530-6100

ACSLP Online Agency Registration
This form is for non-profit agencies who want to host and supervise NCCU student volunteers.
For more information about what is expected of partner agencies, click here.
To view other agencies registered with NCCU's Academic Community Service Learning Program, click here.


Agency Information

Name of Agency [Required] :


Contact Person [Required] :


E-mail [Required] :

Phone Number [Required]:       Facsimile Number:

Address [Required] :    

City [Required] : State [Required]:   Zip [Required]:

Web Site URL:

Time the Agency Opens: [Required]  Closing Time: [Required]

Type of Agency [Required]:   # of Volunteers Needed [Required]:

Mission of the Agency [Required]:    

View other agencies partnered with the ACSLP in the Agency Book.
Note: This is a PDF file requiring the popular, free Adobe Acrobat Reader.


Volunteer Position Information

Volunteer Position Title [Required]:

Location of Service to be Performed [Required]:

Volunteer Start Date [Required]:   End Date [Required]:

Number of Hours [Required]:   Time Preference [Required]:

Volunteer Position Description [Required]:

Volunteer Duties [Required]:

Training-Supervision Provided [Required]:


What skills must the volunteer possess [Required]:


How will this activity be meaningful to the volunteers [Required]:

Can you provide transportation for your volunteers?

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