This form should be used for all chapter-initiated service projects. The form should be submitted within 2 weeks of the date of the service project with all information complete.

Chapter: * - Select -Alpha Xi DeltaDelta Sigma PhiDelta ZetaKappa Alpha ThetaPhi Delta ChiPhi Gamma DeltaSigma Phi EpsilonSigma PiTheta ChiZeta Tau Alpha

Name of Project: *

Location of the Project: *

Brief Description of the Project: *

Date of Project: *

MonthJanFebMarAprMayJunJulAugSepOctNovDec

Day12345678910111213141516171819202122232425262728293031

Year20102011201220132014201520162017201820192020

Number of Members who Participated: *

TOTAL Number of Service Hours: *

Form submitted by (email address): *