Community Service Verification Form
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Email *
Community service is volunteering your time without pay to worthy causes within the Warroad area community. 
Click here for a list of community service facts, tips, rules, and approved civic organizations.

Instructions:
1. Please complete and submit the form below.
2. Maintain a copy for your files to use as a reference during the scholarship application process.
Student First Name *
Student Last Name *
Graduation Year *
Organization Community Service was Performed for *
Date(s) of Community Service *
If your community service was done over multiple days, please list all the dates below
Detailed Description of Services Performed *
Total Number of Hours Volunteered *
Adult Contact #1: Name *
This contact must be able to verify that the above hours and services were done under their supervision and were done on a volunteer basis with no pay. The contact cannot be a relative.
Adult Contact #1: Phone *
Adult Contact #1: Email *
Adult Contact #2: Name (Optional)
This contact must be able to verify that the above hours and services were done under their supervision and were done on a volunteer basis with no pay.
Adult Contact #2: Phone (Optional)
Adult Contact #2: Email (Optional)
By submitting this form, you are approving the accuracy of this entry. 

The submitted information will be verified and any false information reported may result in your ineligibility for scholarships.
Thank you for your service!
A copy of your responses will be emailed to the address you provided.
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