YDSLC -change of information form

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YDSLC - Change of Information Form

Is this change for an existing Youth Driven Service-Learning Center? Or, are you a new center?

New Center
Existing Center

Center Name:

Center Director or Primary Contact:*

School District:*

School Name: *

* indicates required fields
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New YDSLCs: Please fill out all of the following information.

Existing YDSLCs: Only fill in the areas that you would like to change. In that area, include everything that you would like documented.

Primary Email Address:

Primary Phone Number:
- -

Fax: - -

Primary Mailing Address:
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Street Address #1:
Street Address #2:

City:
State: Zip:

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Grant Name:
#1
#2

Center Description / Accomplishments:

Comments: (If this submission is for an existing YDSLC, you may want to indicate what information has changed.)

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The Pennsylvania Service-Learning Alliance dissolved as of June 30, 2007. The website will stay posted for one more year, so please share the resources. We are sorry that we will not be able to answer any questions you may have. Good luck with all your future service-learning endeavors!