Special Event Participation Form

This form must be completed, for each event, by all web based students prior to completing any special event activity. This form is used to determine the appropriateness of your proposed special event with the course objectives and the amount of time and effort contributed. All special events must be community oriented and organized by a recreation or leisure service organization. It is critical that you identify three (3) special events early in the semester and get them approved by the course Instructor. Not completing all three special events required will have a negative impact on your grade. Please complete one form for each special event. You may fax this form to Dr. Charles Hammersley or Judith Hammersley at (928) 523-2275 or e-mail the exact information charles.hammersley@nau.edu or judith.hammersley@nau.edu.  Please contact me (phone or e-mail) if you have any questions.

Special Event Name: ____________________________________________________

Event Date(s): ____________

Organizing Agency's Contact Person's Name: ____________________________________

Job Title: _______________

Organizing Agency Name: _____________________________________________________

Phone: (      )____________    Email: _______________________________________

Organizing Agency Address: (street)________________________________________________

(city) : ______________________ (state): _____________  (zip code): _________________

Special Event Responsibilities

Identify which of the following area(s) you will assist and the estimated number of hours involved in each.

The student will work with event organizers and sponsors to create and implement the tasks associated with their particular area.

Description of Your Duties

Please give a complete description of you duties and responsibilities related to this special event.

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