Berg Service Challenge Commitment Form

This should be the name of the service-site you will be working at or the name of the agency that you are serving for.

I am making the commitment to serve 10 hours Spring 2012 semester and I will contact the organization to work out the details.

Refresh Type the characters you see in this picture.
Type the characters you see in the picture; if you can't read them, submit the form and a new image will be generated. Not case sensitive.  Switch to audio verification.

Siobhan Ryan