Student Service Record

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1	Student Name: _____________________________________________________________________________________
2	Date	Organization Served	Hours	Description of Service	Contact Name and Email or Phone #	Signature of Supervisor**
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21		TOTAL HOURS: ____________
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23	**If you don't have a signature from a supervisor, you may submit another form of documentation to confirm service hours. Parents & relatives cannot sign for service hours. Other acceptable forms of documentation:
24				Email confirmation from supervisor or sponsor, including dates, hours of service
25				Letter from supervisor or sponsor, including dates, hours of service
26				Print out from organization showing service record
27				Copy of service record for an Honor Society or Service Club with signatures.
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