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Community Service Form
Student’s Name::
1. Name of
nonprofit:
Dates
worked:
Type of work
performed:
Name of supervising member of organization
Grade:
Hours of Service:
Signature of supervising member of organization
2. Name of
nonprofit:
Dates
worked:
Type of work
performed:
Name of supervising member of organization
Hours of Service:
Signature of supervising member of organization
3. Name of
nonprofit:
Dates
worked:
Type of work
performed:
Name of supervising member of organization
Hours of Service:
Signature of supervising member of organization
4. Name of
nonprofit:
Dates
worked:
Type of work
performed:
Name of supervising member of organization
Signature of supervising member of organization
Hours of Service: