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Marcus High School CheerleadingCharacter ConductCitizenshipRecord of Community ServiceCheerleader Name: ______________________________ Squad:__________Date of Service:___________________________________________, 201__Place of Service: ________________________________________________Describe Service Performed: _______________________________________ ______________________________________________________________Start Time: ___________am/pm End Time: ____________am/pmTotal Time: __________________ (hours/minutes)Acknowledgement of Community Service127634175259(Service Supervisor Name)(Service Supervisor Name)I _________________________________ hereby verify and confirm that the Hours/minutes and details of service above and were performed by 494030167004(Name of Cheerleader)(Name of Cheerleader)____________________________________.Comments:___________________________________________________________________________________________________________________Name of Organization: ___________________________________________Signature ________________________________Title: _________________Telephone: ____________________________________________________Email__________________________________________________________(This is form will be used for verification purposes. Information may also be individually verified by coaching staff. Thank you for your support of the Edward S Marcus High school cheer program.)

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