STUDENT’S NAME: ____________________________________________ (One student per form please)

        

ACTIVITY: ________________________________________________  

LOCATION : ______________________________________________

DATE: _____________________                           TIMES ___________ - ___________ = _______ Hours

PERSON IN CHARGE:_________________________________________  

THE STUDENT COMPLETED COMMUNITY SERVICE TIME IN THE FOLLOWING MANNER:

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

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SIGNATURE OF PERSON IN CHARGE OF/INVOLVED IN THE ACTIVITY         

Thank you so much for being a part of our children’s education!