Service and Philanthropy Activity Record
Request Form

Please use the form below to request an official copy of an organization's Service and Philanthropy Activity Record. Current and past officers of the organization may request records. Please allow 7-10 business days for your activities to be verified and added to the record.

Questions about the Service and Philanthropy Activity Record can be directed to Bryan Rotach, Assistant Director of Operations of the Rochester Center for Community Leadership.

All Field are Required

Name of Campus Organization (as it is registered):
Name of Individual Submitting Request:
Relationship to the Organization:
Email Address:

Record should include activities
from to

Mail official record to:
Name:
Organization or Title:
Address:
City: State: Zip Code: