COMMUNITY SERVICE
|[pic] |COMMUNITY SERVICE FORM |
Every member of H.H. L. Student Leadership Development must complete 15 hours of volunteer work as part of his/her graduation requirements. Students must:
a) Complete the work for neither money nor credit
b) Have your supervisor verify you completed your hours
Submit this completed form to Old Gym Building, Room 302 on or before __________________
Student Name: _______________________________________________
|DATE HOURS |HOURS |NAME OF AGENCY |TYPE OF WORK PERFORMED |SUPERVISOR’S SIGNATURE |SUPERVISOR’S |
|PERFORMED |WORKED |WHERE | | |PHONE # FOR VERIFICATION |
|(LIST EACH DAY SEPARATELY) |ON THIS DAY |PERFORMED | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| |TOTAL |FOR OFFICE USE ONLY |
| |HOURS |Computer entry |
| | |Total hours entered:____________________ Date entered:___________________ by:________________ |
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