WHC Health Promotions Community Service Hours Form
This form MUST be submitted each day you complete service hours. You must submit this form the day that you complete any hours or else they will not be counted.
First and Last
Please refer to webpage for total hours allowed per specific services
Name of program or event
Name or topic area
Select as many as apply. If not on this list please add.
Select as many as apply
Brief description of what you accomplished today and any specific location including high traffic areas and buildings that you worked in.
Who assigned these tasks to you?
Questions, Comments & Concerns
Is there anything about this task or event that we should know?
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