MCS Volunteer Log Hour Sheet
Email *
Student Name (first and last) *
Student ID # *
Grade Level *
Date(s) of Event *
Location of Service *
Service Provided (be specific) *
Numbers of hours served *If submitting more than 15 hours, an email from supervisor is required. **PLEASE WRITE JUST THE NUMBER (don't write word "hours") Please send email to katelyn.walsh@d214.org*  *
Adult/Supervisor Name *
Adult/Supervisor Phone # *
Adult/Supervisor’s Organization and Job Title *
My volunteer service hours were preformed *
I learned of this volunteer opportunity through RMHS *
I certify that all information provided is true and correct to the best of my knowledge, and understand that any falsification can result in disciplinary consequences, up to and including removal from the MCS program. *
Required
A copy of your responses will be emailed to .
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