LIC Volunteer Hours
LIC volunteer hour forms are due in the SNA office (CHS 381) no later than Tuesday, July 24 at 5:00PM. Late forms will NOT be accepted.
Name_______________________ Theory Class________
SNA Member ___Yes ___No
SNA Position__________________
EVENT
DATE TIMES TOTAL HOURS
Ex. Meijer Kidney Walk
4/30/06 8AM-2PM .
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Do not write below this line
LIC Committee Only
Total Hours________ / 3pts Non-SNA Members
__________ pts
2pts SNA Members
1.5pts SNA Delegate/Alternate
1pt SNA Board Member
SNA Position
__________pts
Committee Participation
__________pts
Miscellaneous
__________pts
Total Points
__________pts
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LIC
Chair Signature
Faculty AdvisorSignature
