MLK Day On! Participant RSVP

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RSVP HERE - Monday, January 18th from 9am-2:30pm

Thank you for participating in the MLK Day On! service experience. This experience will not only be fun and uplifting for you, but it will serve our local community's needs making Iowa City an even better city to live in for all. Because this event is serving the needs of others, it is important that we have an accurate list of who will be attending.

By RSVPing for this event you are agreeing to be present at the event for the full time period on Monday, January 18th from 9am-2:30pm. This is the Monday before classes begin. In exchange for your dedication to serving the community we will provide free breakfast and lunch.

Please fill out this brief form so that we can learn more about you and your organization (if applicable) and so that we may recognize you and your group as one that cares about and engages in community service!

If you have any questions or concerns, please email tayler-wallace@uiowa.edu (Tayler Wallace, Executive Officer of Community Responsibility | The Herky CARES Project)

Your name *

University email *

Student ID *

Phone Number *

Are you participating with a group/ organization? *

Yes

No, I will participate as an individual

If yes, what is the name of your group/ organization?

Emergency Contact Information

This information may be used in the unlikely event of an emergency

Emergency Contact Name *

Relationship to You *

Parent

Sibling

Friend

Other:

Emergency Contact Phone *

Thank you for taking the time to fill out this form. The Herky CARES crew looks forward to your participation in MLK Day On! Please click Submit when finished.

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