Fillable James Logan High School - Community Service Approval Form printable pdf download

James Logan High School - Community Service Approval Form

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James Logan High School – Community Service Approval Form

(Community service projects and upcoming events are posted in the JLHS Career Center or on the JLHS website.)

I N S T R U C T I O N S :

Do BEFORE the event:

 Contact the supervisor of the agency and discuss the work you’d like to do.

 All service must be done at a non-profit organization in possession of an IRS issued 501C form.

 Complete sections 1 and 2 of this form (top & bottom) prior to the event. (Give a complete description of the type

of work, date, time.)

 Parent signature must be included before submitting the form for approval.

 Complete section 3 of the form after completing the activity (must have supervisor signature).

 Submit this form for approval (may take up to 3 days) to the Career Center before attending the event.

SECTION 1

Student Name: __________________________________ ID #: ________________ Class of : _________

House: _____ Counselor: _________________

SECTION 2

Organization: ______________________________ Supervisor Name: _________________________

Phone: ________________________

Start Date: ____ / ____ / ____

Responsibilities:

______________________________________________________________________________________

____________________________

____________

Student Signature

Parent Signature

Date

SECTION 3

Hours Serviced: _______ Completion Date: ___ / ___ / ___ Supervisor Signature: __________________

FOR OFFICE USE ONLY

______________________________

____________

___ /___ /___

____________________

______________________________

Pre-approval / date

Hours Completed

Date

Approval Signature

Total Hours Completed / Date

IMPORTANT NOTE: It is the responsibility of the student to safeguard this form. If lost, complete a new form and verify hours again.

--------------------------------------------------------------------------------------------------------------------------------------------------------------------------

S T U D E N T C O P Y : FILL OUT section 1 and 2 below before submitting form. Retain the copy for your records.

SECTION 1

Student Name: __________________________________ ID #: ___________________ Grade: _____

SECTION 2

Organization: ______________________________

Event Date: ____ / ____ / ____

FOR OFFICE USE ONLY:

Student completed _________ hours of community service on date listed above and now has a total of _________

hours completed.

____________________

___ /___ /___

Approval Signature