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SERV Hours Report

Please complete the following information to report SERV hours for your NSU student organization. Individual NSU students may also report their SERV hours by using this form.

Note: All fields with an * are required.

Student Information

First Name *
A value is required.

Last Name *
A value is required.

Phone *
A value is required. Invalid format.

Email *
A value is required. Invalid format.

N Number *
A value is required.
Invalid format.

Class Rank * --Select One-- Freshman Sophomore Junior Senior Graduate Student
Please select an item.

Campus * --Select One-- Main Campus/Ft. Lauderdale Bahamas Fort Myers Jacksonville Miami/Kendall Oceanographic Center Orlando Palm Beach Tampa
Please select an item.

I am submitting these SERV hours on behalf of * --Select One-- Myself My NSU Student Organization
Please select an item.

I need documentation of these SERV hours for the purposes of employment, scholarship, or admission applications * --Select One-- Yes No
Please select an item.

Sponsoring Organization Information

Name of Organization *
A value is required.

Name of Contact Person *
A value is required.

Phone Number *
A value is required.
Invalid format.

Email *
A value is required.
Invalid format.

SERV Hours Information

Name of Event/Initiative *
A value is required.

Date *
A value is required.
Invalid format.

Location *
  characters remaining A value is required. Exceeded maximum number of characters.

Description *
  characters remaining A value is required. Exceeded maximum number of characters.

How many individuals—including yourself—participated in this event/initiative *

(Maximum value of 30)

A value is required.
Invalid format.
The entered value is less than the minimum required.
The entered value is greater than the maximum allowed.

Student 1

NSU Student's Name *
A value is required.

NSU Student's N Number
A value is required.
Invalid format.

Number of Hours Served * (Maximum value of 15)
A value is required.
Invalid format.
The entered value is less than the minimum required.
The entered value is greater than the maximum allowed.

Student 2

NSU Student's Name *
A value is required.

NSU Student's N Number
A value is required.
Invalid format.

Number of Hours Served * (Maximum value of 15)
A value is required.
Invalid format.
The entered value is less than the minimum required.
The entered value is greater than the maximum allowed.

Student 3

NSU Student's Name *
A value is required.

NSU Student's N Number
A value is required.
Invalid format.

Number of Hours Served * (Maximum value of 15)
A value is required.
Invalid format.
The entered value is less than the minimum required.
The entered value is greater than the maximum allowed.

Student 4

NSU Student's Name *
A value is required.

NSU Student's N Number
A value is required.
Invalid format.

Number of Hours Served * (Maximum value of 15)
A value is required.
Invalid format.
The entered value is less than the minimum required.
The entered value is greater than the maximum allowed.

Student 5

NSU Student's Name *
A value is required.

NSU Student's N Number
A value is required.
Invalid format.

Number of Hours Served * (Maximum value of 15)
A value is required.
Invalid format.
The entered value is less than the minimum required.
The entered value is greater than the maximum allowed.

Student 6

NSU Student's Name *
A value is required.

NSU Student's N Number
A value is required.
Invalid format.

Number of Hours Served * (Maximum value of 15)
A value is required.
Invalid format.
The entered value is less than the minimum required.
The entered value is greater than the maximum allowed.

Student 7

NSU Student's Name *
A value is required.

NSU Student's N Number
A value is required.
Invalid format.

Number of Hours Served * (Maximum value of 15)
A value is required.
Invalid format.
The entered value is less than the minimum required.
The entered value is greater than the maximum allowed.

Student 8

NSU Student's Name *
A value is required.

NSU Student's N Number
A value is required.
Invalid format.

Number of Hours Served * (Maximum value of 15)
A value is required.
Invalid format.
The entered value is less than the minimum required.
The entered value is greater than the maximum allowed.

Student 9

NSU Student's Name *
A value is required.

NSU Student's N Number
A value is required.
Invalid format.

Number of Hours Served * (Maximum value of 15)
A value is required.
Invalid format.
The entered value is less than the minimum required.
The entered value is greater than the maximum allowed.

Student 10

NSU Student's Name *
A value is required.

NSU Student's N Number
A value is required.
Invalid format.

Number of Hours Served * (Maximum value of 15)
A value is required.
Invalid format.
The entered value is less than the minimum required.
The entered value is greater than the maximum allowed.

Student 11

NSU Student's Name *
A value is required.

NSU Student's N Number
A value is required.
Invalid format.

Number of Hours Served * (Maximum value of 15)
A value is required.
Invalid format.
The entered value is less than the minimum required.
The entered value is greater than the maximum allowed.

Student 12

NSU Student's Name *
A value is required.

NSU Student's N Number
A value is required.
Invalid format.

Number of Hours Served * (Maximum value of 15)
A value is required.
Invalid format.
The entered value is less than the minimum required.
The entered value is greater than the maximum allowed.

Student 13

NSU Student's Name *
A value is required.

NSU Student's N Number
A value is required.
Invalid format.

Number of Hours Served * (Maximum value of 15)
A value is required.
Invalid format.
The entered value is less than the minimum required.
The entered value is greater than the maximum allowed.

Student 14

NSU Student's Name *
A value is required.

NSU Student's N Number
A value is required.
Invalid format.

Number of Hours Served * (Maximum value of 15)
A value is required.
Invalid format.
The entered value is less than the minimum required.
The entered value is greater than the maximum allowed.

Student 15

NSU Student's Name *
A value is required.

NSU Student's N Number
A value is required.
Invalid format.

Number of Hours Served * (Maximum value of 15)
A value is required.
Invalid format.
The entered value is less than the minimum required.
The entered value is greater than the maximum allowed.

Student 16

NSU Student's Name *
A value is required.

NSU Student's N Number
A value is required.
Invalid format.

Number of Hours Served * (Maximum value of 15)
A value is required.
Invalid format.
The entered value is less than the minimum required.
The entered value is greater than the maximum allowed.

Student 17

NSU Student's Name *
A value is required.

NSU Student's N Number
A value is required.
Invalid format.

Number of Hours Served * (Maximum value of 15)
A value is required.
Invalid format.
The entered value is less than the minimum required.
The entered value is greater than the maximum allowed.

Student 18

NSU Student's Name *
A value is required.

NSU Student's N Number
A value is required.
Invalid format.

Number of Hours Served * (Maximum value of 15)
A value is required.
Invalid format.
The entered value is less than the minimum required.
The entered value is greater than the maximum allowed.

Student 19

NSU Student's Name *
A value is required.

NSU Student's N Number
A value is required.
Invalid format.

Number of Hours Served * (Maximum value of 15)
A value is required.
Invalid format.
The entered value is less than the minimum required.
The entered value is greater than the maximum allowed.

Student 20

NSU Student's Name *
A value is required.

NSU Student's N Number
A value is required.
Invalid format.

Number of Hours Served * (Maximum value of 15)
A value is required.
Invalid format.
The entered value is less than the minimum required.
The entered value is greater than the maximum allowed.

Student 21

NSU Student's Name *
A value is required.

NSU Student's N Number
A value is required.
Invalid format.

Number of Hours Served * (Maximum value of 15)
A value is required.
Invalid format.
The entered value is less than the minimum required.
The entered value is greater than the maximum allowed.

Student 22

NSU Student's Name *
A value is required.

NSU Student's N Number
A value is required.
Invalid format.

Number of Hours Served * (Maximum value of 15)
A value is required.
Invalid format.
The entered value is less than the minimum required.
The entered value is greater than the maximum allowed.

Student 23

NSU Student's Name *
A value is required.

NSU Student's N Number
A value is required.
Invalid format.

Number of Hours Served * (Maximum value of 15)
A value is required.
Invalid format.
The entered value is less than the minimum required.
The entered value is greater than the maximum allowed.

Student 24

NSU Student's Name *
A value is required.

NSU Student's N Number
A value is required.
Invalid format.

Number of Hours Served * (Maximum value of 15)
A value is required.
Invalid format.
The entered value is less than the minimum required.
The entered value is greater than the maximum allowed.

Student 25

NSU Student's Name *
A value is required.

NSU Student's N Number
A value is required.
Invalid format.

Number of Hours Served * (Maximum value of 15)
A value is required.
Invalid format.
The entered value is less than the minimum required.
The entered value is greater than the maximum allowed.

Student 26

NSU Student's Name *
A value is required.

NSU Student's N Number
A value is required.
Invalid format.

Number of Hours Served * (Maximum value of 15)
A value is required.
Invalid format.
The entered value is less than the minimum required.
The entered value is greater than the maximum allowed.

Student 27

NSU Student's Name *
A value is required.

NSU Student's N Number
A value is required.
Invalid format.

Number of Hours Served * (Maximum value of 15)
A value is required.
Invalid format.
The entered value is less than the minimum required.
The entered value is greater than the maximum allowed.

Student 28

NSU Student's Name *
A value is required.

NSU Student's N Number
A value is required.
Invalid format.

Number of Hours Served * (Maximum value of 15)
A value is required.
Invalid format.
The entered value is less than the minimum required.
The entered value is greater than the maximum allowed.

Student 29

NSU Student's Name *
A value is required.

NSU Student's N Number
A value is required.
Invalid format.

Number of Hours Served * (Maximum value of 15)
A value is required.
Invalid format.
The entered value is less than the minimum required.
The entered value is greater than the maximum allowed.

Student 30

NSU Student's Name *
A value is required.

NSU Student's N Number
A value is required.
Invalid format.

Number of Hours Served * (Maximum value of 15)
A value is required.
Invalid format.
The entered value is less than the minimum required.
The entered value is greater than the maximum allowed.

Total service hours: 0

Please describe how you or your student organization contributed to the community *
  characters remaining
A value is required.
Exceeded maximum number of characters.

I recommend this event/initiative to other NSU students or student organizations * --Select One-- Yes No
Please select an item.

By checking the following box, I certify that all of the information submitted on this form is true and accurate *
Please make a selection.