I'd like to learn more about Civic House
Please contact me with more information

Name School/Year

Address

City State Zip

Email

Would you like to receive periodic updates about Civic House activities Yes    No  

Phone

What Civic House programs/activities were you involved with during your time at Penn?
(check all that apply)

PennCORP

West Philadelphia Tutoring Project

Student Service & Advocacy Group(s)  
Group Name(s)

Other   Please specify

Since graduating, have you been or are you currently involved in volunteer work/civic engagement activites?

Yes    No    If yes, please specify

Do you have or are you currently pursuing a graduate/professional degree?

Yes    No      Granting Institution/type of degree

Have you, in the past or currently been employed in the non-profit or public sectors?

Yes    No      Employer/Dates of employment (MM-YY)

In what ways are you interested in staying involved with the Civic House community?
(check all that apply)

Participate in a panel disscussion about post-graduate service/public interest careers

Mentor Civic House students who share your volunteer/career interests (via phone/email)

Sharing information about your volunteer experiences for inclusion in Civic House literature

Returning to campus to attend Civic House programs

In what ways can Civic House serve as a continuing resource for you?
(check all that apply)

Scheduling informal Civic House alumni networking opportunities

Additional communications throughout the year       Please specify

Posting internship and job opportunites within your organization for current students

Other ways      Please specify

Thank you for providing us with your information. We will be in contact with you soon!