High School Community Service Form printable pdf download

High School Community Service Form

SERVICE MUST BE HELPING PEOPLE (NON-FAMILY MEMBERS) IN NEED OR FOR A

NON-PROFIT ORGANIZATION

High School Community Service Form

*PLEASE PRINT*

STUDENT INFORM ATION: (Com pleted by student)

Student Name:

ID#:

GRADE: ____

Address:

City:

State: TX Zip:

Phone:

Graduation Year:

Student Signature:

Parent Signature:

Organization/Agency Sponsor Information: (

completed by student and/or sponsor)

Name of Organization/Agency

Non-Profit

/ N

Name of Sponsor:

DAYTIME PHONE:

Address:

City:

State:

Zip:

Contact’s Email: ________________________________________________________

Brief purpose of organization:

Describe briefly the volunteer activity/activities to be perform ed by th e student including # of

hours:

Date Work Started:

Date Work Com pleted:

AFTER

Sponsor: (Complete

student has concluded participation in the activity described)

I certify that the above student has com pleted

community service hours and that these

hours are NOT A RESULT OF COURT ORDERED COMMUNITY SERVICE HOURS.

(COURT ORDERED HOURS ARE

NOT ACCEPTED)

Sponsor Signature:

Date:

(SIGNATURE MAY NOT BE STUDENT’S PARENT OR GUARDIAN)

High School Community Service Form