Community Service Time Sheet
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1
2A complete set of Community Service Guidelines can be found at
:
Grade level
under “Students”
Year student graduates:
SJUSD Community Service Time Sheet
Students are required to complete 40 hours of community service to graduate. The following guidelines apply:
1.Community Service is defined as volunteer service for an approved non-profit agency.
2.As a general rule, students should earn 10 hours of CS each year but schools are allowed to implement their own hourly programs such as Pioneer (30 hours sophomore year) and hold students
accountable for hours to attend various activities. Hours can begin to be accumulated during the summer before their freshman year. It is wise to have your CS opportunity approved by the
administration prior to volunteering to insure that the agency qualifies and to guarantee your hours will be accepted.
3.Please check with your school administrator regarding community service credit for religious community service.
4.Hours accrued through Camp Campbell or Walden West are limited to a maximum of 20 per camp session.
5.Approved service for nonprofit agencies completed during the weekends or vacation time will be limited to no more than 8 hours a day.
6.Service hours completed on school days will be given for service completed after the normal school hours; service hours cannot be given for club meetings.
7.Make sure that this form clearly states the non-profit agency, contact person, and phone number so that its non-profit status and your service hours can be verified. Incomplete forms will be rejected.
(A complete list of guidelines can be found at
or contact the A. P. or Director of Activities at your school. Keep a copy of this form for your records.)
Last Name:
First Name:
Student ID:
School:
Date
Hours
Non-Profit Agency Name
Agency Phone Number
Supervisorʼs Name- please print
Supervisorʼs Name- please print
Supervisorʼs Signature
/ /
/ /
/ /
/ /
/ /
/ /
/ /
/ /
/ /
/ /
Total:
A.P. or Director of Activities Signature:
A.P. or Director of Activities Signature:
A.P. or Director of Activities Signature:
Studentʼs Signature:
Studentʼs Signature:
Parentʼs Signature:
Parentʼs Signature:
Date:
Please note: Only original forms will be accepted- copies will be rejected. The back of this form must be completed by your supervisor or the form will be returned.
External Programs: Erlendson/Fuqua/ revised 1/24/10
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