Substitute Community Service Project Form
for Distinguished Membership Points

We recognize that KDP: Tau Epsilon Chapter is not the only organization on campus involved with community service projects. Nor could it possibly manage to help communities beyond the Ann Arbor Area efficiently and effectively. We want to commend you, and award you distinguished membership points, for your involvement with such projects in your own area. In order to receive credit for your outside event involvement you must document the items found in the form below. Once your project is complete please fill out this form and submit it for credit. The Membership Chairperson will follow-up with you once the submission is received and processed.

KDP Member Information
1. Your Name:
        (first and last)
2. Your E-mail*:
        *must enter this field to successfully submit this form
3. Your Member #:
        (if known)

Event Information
4. Name of event:
5. Date of event:
6. Name of sponsoring organization:
7. Target audience or group of participants is:
8. Purpose of event:
9. Goal for this year's occasion:

10. Was the goal met? yes no
11. Why or why not?


12. Number of hours you spent at the event:
13. Define your role during the actual event time:

14. Describe the benefit you received from being involved with the event:


15. Did you help plan the event?
yes (please answer questions 16 & 17 as well)
no (please skip to question 18)
16. Number of hours you helped in planning the event:
17. Define your role during the planning:


Event Verification
In order to complete the submission process we must be able to verify
your involvement with the event. Please provide the following information
for us to contact the event coordinator who can confirm your answers
in questions 4-8, 12, and 15-16 above.
18. Name of event coordinator:
19. E-mail of event coordinator:
20. Phone # of event coordinator: