Community Service Assignment Form Page 2
Download a blank fillable Community Service Assignment Form in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Community Service Assignment Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2Community Service Assignment Form
Assignment Information
13. Assignment date_______________________________(MM/DD/YYYY)
14. Start assignment date ___________________________ (MM/DD/YYYY)
15. End date _____________________________________(MM/DD/YYYY)
16. Starting wage (per hour) $ ______________________
17. Community service assignment code_______________(Select only one code from
following list)
Service to the general community includes the following activities:
1. Education
6. Environmental Quality
11. Counseling
2. Health and Hospitals
7. Public Works & Transportation
12. Conservation
3. Housing and Home Rehabilitation
8. Social Services
13. Community Betterment
4. Employment Assistance
9. Legal
14. Other______________
5. Recreation, Parks, and Forests
10. Financial
______________________
Service to the elderly community includes the following activities:
15. Project Administration
20. Nutrition Programs
25. Counseling
16. Health and Home Care
21. Transportation
26. Conservation
17. Housing and Home Rehabilitation
22. Outreach/Referral
27 Community Betterment
18. Employment Assistance
23. Legal
28. Other______________
19. Recreation/Senior Centers
24. Financial
______________________
18. Community service assignment title _______________________________________
19. Total hours paid in quarter
Quarter 1 ________________
Quarter 3 ________________
Quarter 2 ________________
Quarter 4 ________________
20. Types of training received (Check all that apply)
a. On-the-community-service-job-training
d. On-the job-experience (OJE)
b. Generalized skill training
e. Trial employment
c. Specialized training
f. Other (specify)_________________
21. Total hours of paid training received in quarter
Quarter 1 ________________
Quarter 3 ________________
Quarter 2 ________________
Quarter 4 ________________
22. Community service assignment comments
2
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form Dr-700025 - Objection To Address/jurisdiction Database For Local Communications Services Tax And Local Insurance Premium Tax Service Address Assignment
Financial
Form Dr-700025 - Objection To Address-jurisdiction Database For Local Communications Services Tax And Local Insurance Premium Tax Service Address Assignment
Financial
Form Dr-700025 - Objection To Address/jurisdiction Database For Local Communications Services Tax And Local Insurance Premium Tax Service Address Assignment
Financial
Form Dr-700025 - Objection To Address/jurisdiction Database For Local Communications Services Tax And Local Insurance Premium Tax Service Address Assignment
Financial
Related Categories
Parent category: Business