Community Service Project Proposal Page 3

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ACTIVITY LOG FORM
Addendum C
All students must use the Activity Log Form to record their community service activities.
Use additional sheets as needed.
DATE
COMMUNITY SERVICE ACTIVITIES
SUPERVISOR’S
**HOURS
SIGNATURE
COMPLETED
** TOTAL PROJECT HOURS:
_________________________________
_______________________________
Parent/Guardian Signature
Student’s Signature
______________________________________________
Signature of Teacher, Counselor, or Principal’s Designee
______________________________________________________________________
**
Only students working to meet the requirements for the Florida Academic Scholars certificate or
the Superintendent’s Diploma of Distinction need to complete the “Hours Complete” section of
the Activity Log form.

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