Verification Of Community Service

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Verification   o f   C ommunity   S ervice  
Student   N umber   _ __________________________  
Student   N ame   _ _____________________________________________  
Grade_______________________     A cademy   _ _____________________________________  
 
Date   o f  
Total   #  
Volunteer   O rganization  
Activity   o r   T ask   P erformed  
Name   o f   V erifier  
Verifier’s   S ignature  
Verifying   P hone  
Service  
Hours  
Number  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

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Parent category: Miscellaneous
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