Community Service | Macaulay Forms

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.

You must submit this online Community Service form, and receive approval from your MHC honors advisor before participating in 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*
Campus*
Class*
Name*
First Last
Phone*
Preferred Email*
Organization Information
Organization Name*
Organization Address*
Street Address Address Line 2 City State ZIP Code
Community Service Information
Hour(s) of Service*
Number only (e.g. 5.5. No sign "+")
Description of Service*
Start Date*
MM slash DD slash YYYY
End Date*
MM slash DD slash YYYY
Supervisor Information
Name*
First Last
Title*
Supervisors Phone*
Supervisor Email*
Hidden
Supervisor Signature
Date
MM slash DD slash YYYY
Virtual Service
Is this service virtual?*
- Yes
- No
Advisor*
Please type in your advisor's name*
In-person community service project waiver*
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

Student Contact Information

Organization Information

Community Service Information

Supervisor Information

Virtual Service