ࡱ > { J bjbjBrBr . v N N 8 2 2 2 [ ] ] ] ] ] ] $ z , p 2 2 d 2 2 [ [ 2 `?Ĕ q R G 0 @ D N n : Student Group Application Form Name of Student Group________________________________________________________ Student Group Email___________________________________________________________ Contact Person _________________________________________________________________ Contact Email ___________________________________________________________________ Contact Phone Number _______________________________________________________ Contact Box Number _______________________ Does your group have a car / transportation? YES NO Please check one: Would you like to Adopt a resident for the year _______ Adopt a resident for a semester? _______ Help on as-needed basis? _______ Names of student volunteer participants: ___________________________________ ____________________________________ ___________________________________ ____________________________________ ___________________________________ ____________________________________ ___________________________________ ____________________________________ ___________________________________ ____________________________________ Thank you! ECAP: Elizabethtown Community Assistance Program Elizabethtown College Center for Community & Civic Engagement Nicarry 237 (717) 367-3025 HYPERLINK "mailto:ECAP@etown.edu" ECAP@etown.edu ! " o % > X \ ^ _ n p q ٸwdwdwwdWJ h=\ 5CJ OJ QJ aJ h5 5CJ OJ QJ aJ %haH haH 56>*CJ OJ QJ aJ "haH haH 56CJ OJ QJ aJ "haH haH 5>*CJ OJ QJ aJ haH 5CJ OJ QJ aJ haH haH 5CJ OJ QJ aJ h 5>*CJ OJ QJ aJ "h>Q haH 5>*CJ OJ QJ aJ haH 5>*CJ OJ QJ aJ hG h j h)T haH UmH nH u ! " p c ' g B gdG $ a$gd5 $ a$gdaH $ a$gdaH $a$gdG j k u v w y z | } 6 7 E F G H I J xxgxc_ h!N haH h>Q haH >*B*OJ QJ ph j h>Q haH OJ QJ UhaH OJ QJ h>Q haH OJ QJ h>Q haH CJ OJ QJ h>Q haH CJ$ OJ QJ hX5 j hX5 UhG haH 5CJ OJ QJ aJ hG 5CJ OJ QJ aJ hG h=\ h=\ 5CJ OJ QJ aJ h5 5CJ OJ QJ aJ % j k v x y { | ~ G H I J $a$gdaH $ H$d a$gdaH d gdaH $ a$gdG $ a$gd5 gdG , 1h/ =!"#$% 2 D d K: z z V Q h t: B A ? P i c t u r e 1 b d :9lLi } @ D j n8 :9lLi }PNG IHDR sRGB gAMA a pHYs od IDATx^ Uyuz<^urDFQ$CP