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Completion of Community Involvement Activities

Student’s Name                                                                        Principal’s Name                

                                                                                               Ms. Kristen Fregeau

                                                                                           

School                                                                                 Address and Telephone Number

    Beaver Brae Secondary                                                             1400 Ninth Street N.  Kenora, ON     (807) 468-6401

                                                         

Please submit this form to the school when you have completed 40 hours of community involvement activities, when the principal requests it or when this sheet is full.

                                                                        

Activity

Number of Hours

Date

Location and telephone number

Supervisor’s name and signature

                                             Total                                                                                                                                                                                                                                                                        

Student’s Signature                                        Date

Parent’s Signature                                        Date