Free community service form 32
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Community Service Hours Form
Turn into your counselor
Student Information
First and Last Name:
Organization Information
Name of Agency, Club and/or
Organization
Address
Supervisor Name
Telephone number
Organization’s Tax ID #
Brief
Description of
Activity

Date

Time in

Time Out # of hours
(rounded to
nearest 0.5
hours)

Signature of Site
Supervisor

Total Hours=
*DC graduation requirements require 100 hours of community service. For DCI, we have additional requirements depending on which
program students enter in 11th grade. For the Diploma program students will be asked to complete Community, Action and Service
projects; for the Career Program they will complete a Reflective Project in a field related to their chosen career pathway.

www.dcinternationalschool.org

202.808.9033

1400 Main Dr NW, Washington, DC 20012