Central High School Community Service (Page 2 of 3) in pdf

Central High School Community Service Page 2

Individual Service

Supervisor’s Comments

This form is to be filled out by the person supervising you with this service project/s. This form

needs to be turned in upon completion of your hours. Make copies as needed.

Name________________________________________________________Grade___________________

Service Project Name____________________________________________________________________

Thank you in advance for completing this form. This sheet will be kept in the student’s file and is an

important element of his/her file. Please place a check mark in front of the appropriate statement based on

the student’s performance in the activity (please be honest), and feel free to write a brief comment if

necessary. You may fax, mail, or return this form to the student.

Central High School

2400 Dobbs Drive

Phenix City, AL 36870

Phone: 334-298-3626 Fax: 334-298-0970

_________The student has successfully completed approximately _________hours of service for

this activity/project.

COMMENTS:

_____________________________________________________________________________________

_________The student has completed approximately _________ hours, but his/her character,

willingness, or behavior was unsatisfactory in doing so. (Please write a brief comment as to what

made them unsatisfactory.)

COMMENTS:

_____________________________________________________________________________________

Supervisor’s Signature ______________________________Date_________________________________

Phone Number___________________________ or Email_______________________________________

Central High School Community Service Page 2