STEP Application Form

Student name: _______________________________________________________________

School: _____________________________           Level in school: ____________________

Email: _______________________________          Phone: ____________________________

 Brief description of activity:

1._______________________________________________________________________________________

2._______________________________________________________________________________________

3._______________________________________________________________________________________

4________________________________________________________________________________________

5.________________________________________________________________________________________

If needed, list additional activities on back or attach separate page.

 Documentation & verification of activity/activities:

Date___Activity        _Hours____# of attendees _________Signature & position of supervisor

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

If needed, list additional activities on back or attach separate page.

Proof:  Don’t forget to submit proof of your activity/activities in addition to documentation of hours and number of attendees.  Pictures or video must show you and the audience/attendees.  Alternatively or in addition, keep online, electronic or printed evidence (newspaper article, posts, attendee evaluations, etc.) of your activity.  Submit pics/video/electronic/print proof to info@hope4justice.org

Submit signed form and documentation to Hope4Justice, 600 Front St., #502, Lynden, WA 98264 by submission deadline of April 15.  No exceptions.

If you are unable to print this Form, please email info@hope4justice.org