STUDENT VOLUNTEER SERVICE PROGRAM
Tier II/Tier III Log Sheet
Student Name: _________________ Student Number: _________________ Graduation Year: _______
School Name: __________________ School Year: ______________________ Grade Level : ____________
Name of Organization with which the service is being performed:
Submitting this log sheet to the Student Volunteer Service Program Coordinator does not mean that the hours indicated on it will automatically be applied to the
Student Volunteer Service Program. All volunteer hours are subject to verification.
Students wishing to apply the hours indicated on this sheet to the Florida Academic Scholars Program should take note of the institutions and form on the back of this
sheet. For hours to be considered for the Florida Academic Scholars Program the reverse side of this sheet must be filled out and a duplicate of this sheet must be
submitted to the Guidance Department.
If service hours indicated on this sheet are with or for an organization not sponsored by the school, they will not count in the Student Volunteer Service Program unless
you have a copy of the Student Volunteer Service Application and Approval Form signed by the Student Service Program Coordinator.
Students should make a copy of this for before it is submitted and keep that copy for their records.
Activity or Task Performed
Contact Person’s Signature