Community Service Form.xls
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Student Name
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Organization Name
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Organization Contact
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Telephone Number
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DateDescription of Volunteer DutiesHours Business/Organization Contact Signature
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Student Name
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Business/Organization Name
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1. What do you know about the business or organization in which you plan to complete your community service?
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2. Why did you choose this business or organization?
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3. What specific work did you do and how did it impact you?
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4. From your experience do you think this could be an area you would like to pursue employment in the future?
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Community Service Guidelines
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1. Students must complete 10 hours per school year.
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2. Community service must be completed with a non-profit agency (church, civic group, school, library, NC Turkey Festival, etc.)
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3. The organization's contact person must be at least 21 years old.
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4. Students are expected to complete the hours as designated by the agency.
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5. Students understand that any information obtained during the service learning experience, formally or informally, must
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be kept in strict confidence.
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I have read the guidelines and fully understand what is expected of me to successfully complete community service.
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Student Name:
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Student Signature:
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Parent Name:
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Parent Signature:
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Date:
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