Engagement Honor Roll
Student Name:
Student Email:
Student Phone #:
Student ID #:
MSU or Community Supervisor Name:
MSU or Community Supervisor Department/Affiliation or Organization:
Supervisor Email:
Supervisor Phone #:
Type of Engagement Activity:
Civic Engagement
Community-Based Problem Solving
Leadership Development
Service-Learning
Volunteerism/Community Service
Other
Completion Date of Engagement Activity:
Number of Hours Completed:
Description of Activity:
Submit
Should be Empty: