Independent Volunteer Log

Please Complete and Return

INDEPENDENT VOLUNTEER LOG

Mail: P.O. Box 15643, San Antonio, TX 78212

Fax: 210-598-2610

Participant Name: ________________________________________

Scan:

Organization: ____________________________________________

Event

Event Name and

Hours

Description of Project (work you have

Supervisor’s Name

Comments/Evaluation by

Date

Location

Earned

done that day)

(printed), Signature and

Supervisor

Phone #

Deadline to Submit All Service Hours:

High School Seniors- May 31

Total Hours ____________

All Other Kym’s Kids Participants- July 31

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Parent category: Miscellaneous