National Honor Society Summer Service Hours Form
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1
2National Honor Society Summer Service Hours Form
Student Name (print): ______________________________ School Name: _____________________
Activity/Organization Name and
Hours
Date(s)
Supervising Adult Name,
Supervising Adult
Description of Volunteer work
completed
work
Phone/Email (please print)
Signature
completed
1.
________________________
____________________
PH/EM:
Date:
2.
________________________
____________________
PH/EM:
Date:
3.
________________________
____________________
PH/EM:
Date:
4.
________________________
____________________
PH/EM:
Date:
5.
________________________
____________________
PH/EM:
Date:
6.
________________________
____________________
PH/EM:
Date:
7.
________________________
____________________
PH/EM:
Date:
TOTAL HOURS:
I certify that the information presented above is a complete and accurate record of my summer service activities.
Student Signature: ____________________________________________ Date: ________________
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