Movers & Shakers Interest Form
Please fill in the form below. You will be receiving a Movers & Shakers Contract by email - make sure you fill it out and return it to the Office of Leadership & Service Learning to confirm your spot. Spots for Movers & Shakers are filled on a first come, first served basis.
Cell Phone Number
Where will you be living for Fall 2014?
Longwood University Residence Hall
Longwood University Apartment Community (Landings, Village, Lancer Park)
Are you interested in serving as a Location Supervisor for a total of 8 community service hours?
Do you need any special accommodations?
Do you have any dietary restrictions or allergies?
Is there anything we need to know that wasn't asked?
Do you acknowledge that you must complete the contract that the Office of Leadership & Service Learning will email to you to confirm your spot as a 2014 Mover & Shaker?
Should be Empty: