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Purvis High School - Service Hours
Complete the following information in order to submit the activity for consideration for service hours. Print a copy for your records prior to submitting your form.
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* Required
Student Name
*
Your answer
Grade for 2022-2023 School year
*
Choose
9
10
11
12
Date of Service
*
Your answer
Number of Hours Worked
*
Select amount of time from list. Do not include breaks.
Choose
30 minutes
1 hour
1.5 hours
2 hours
2.5 hours
3 hours
3.5 hours
4 hours
4.5 hours
5 hours
5.5 hours
6 hours
6.5 hours
7 hours
7.5 hours
8 hours
8.5 hours
9 hours
9.5 hours
other - specify
Supervisor's Name
*
Include person's contact number if outside of school.
Your answer
Type of Service
*
Identify the type of volunteer service from one of the categories below.
Choose
Educational and School Related
Medical Volunteer
Sports Volunteer
Feeding and Clothing Those in Need
Charity Event Participation (not fundraising)
Community Service Volunteer
Church Volunteer
Other
From the list below, identify the specific type of volunteer work done.
*
Choose
Tutoring
Helping in a classroom outside of my normal class time
Book drive
Campus beautification
Hospital volunteer
Assisting at a Senior Center
Performing at a Senior Center
Volunteer Coaching
Refereeing (not paid)
Working at a food bank
Working at a soup kitchen
Conducting a clothing drive
Volunteering at a marathon or race event, such as Race for the Cure
Senior Dinner
Coordinating dance event for non-profit
Assisting with silent auction to benefit charity
Work at an animal shelter or resuce center
Road Cleanup
River/creek Cleanup
Habitat for Humanity
Vacation Bible School Worker
Working with handicapped individuals
Building or repairing homes for individuals (non-paid)
Mission work
Other
Write a brief description of the work you performed.
*
Your answer
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