Forms
Community Service
Student Contact Information
To satisfy the Macaulay requirement for service:
You must complete a minimum of 30 hours of community service, with a minimum of 10 hours during each of your first three years at Macaulay. Individual campuses may require additional community service hours.
You may not count an activity for which you are compensated in any form (e.g. monetary, material gifts or service in-kind) towards your community service requirement. Unpaid internships, including those at nonprofit organizations or government agencies, are not considered community service.
Political campaigning or participating in religious service such as proselytizing, faith-based instruction, or other acts as an expression of faith are not considered community service.
If you are unsure if your service will fulfill the requirement, be sure to reach out to your advisor.
You will receive an email with your form responses, which you must print or save as a PDF. The supervisor of the service you participate in must sign the form. Alternatively, students may provide their advisor with a confirmation email from the service supervisor confirming the hours.
Reflect on your Community Service experience with an optional journaling exercise by visiting
https://macaulay.cuny.edu/servicereflection
EMPLID
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Community Service Information
Hour(s) of Service
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NUMBERS ONLY (e.g. 5.5. No sign “+”)
Description of Service
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Start Date
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MM slash DD slash YYYY
End Date
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MM slash DD slash YYYY
Supervisor Information
Name
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First
Last
Title
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Supervisors Phone
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Supervisor Email
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This field is hidden when viewing the form
Supervisor Signature
Date
MM slash DD slash YYYY
Virtual Service
Is this service virtual?
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Yes
No
Advisor
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Select
Ms. Aisha Abdelmula
Ms. Sandy Alexandre
Mr. Vasiliy Arkanov
Mr. William Burgos
Dr. James Clarke
Ms. Lisa French
Ms. Cristina Gleicher
Ms. Varinia Grannum
Mr. Navdip Hans
Mr. Troy Heffron
Ms. Amorita Jones, MSW
Ms. Joanna Kata
Ms. Kseniya Kosmina
Mr. William Lung
Mr. Andy Piña
Ms. Anita Romano
Mr. Benjamin Ross
Dr. Lev Sviridov
Ms. Georgia Southern-Penn
Dr. Irina Stoyanova
Ms. Lena Tuck
Mr. Lorenzo Van Ness
Ms. Jaime Weiss
Other
Please type in your advisor's name
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In-person community service project waiver
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I acknowledge that my participation in an in-person community service project will involve risks and hazards not found in remote community service, which is the current mode recommended by CUNY. In ordinary times, these risks can range from a) minor injuries and illness such as bruises, and strains, to b) major injuries and illness such as broken limbs, loss of sight, neck or back injuries, heart attacks, and concussions, to c) catastrophic injuries, including paralysis and death, and also include risks of damage to or theft of personal property, and risks involved in traveling to and within, and returning from, internship sites. I understand that COVID-19 presents unique health risks, especially to those with underlying conditions, and that there may be other risks not known or reasonably foreseeable. I have sought and obtained information and advice that I feel are necessary and appropriate. I VOLUNTARILY ACCEPT AND ASSUME ALL OF THE RISKS IN PARTICIPATING IN THE COMMUNITY SERVICE PROJECT and my participation in the community service described above is voluntary.
I agree
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