Lake Worth High School Community Service Hours Time Sheet

LAKE WORTH HIGH SCHOOL

COMMUNITY SERVICE HOURS TIME SHEET

STUDENT NAME:__________________________________Student#_______________Grade:_______

Agency:_______________________ Supervisor’s Name:_____________________________

Phone#________________________ Guidance Counselor: ___________________________

DATE(S)

HOURS

SUPERVISOR’S SIGNATURE

TOTAL HOURS: _________________

DATE SUBMITTED:___________________

*20 Community Service hours are required for graduation, prom, grad night, and parking decals. All seniors

must submit their hours by December 2, 2013 of their senior year.

*Please KEEP A COPY for your records.

Student Signature:___________________________________________________

**TURN IN HOURS TO MRS. VELEZ IN GUIDANCE OR AT THE COUNSELING CORNER**

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