Community/Volunteer Service Verification Form
School District of Manatee County
(This form must be completed and all signatures obtained prior to starting a volunteer service project.)
Student Name: ____________________________________________ |
Date: ____________ |
School: __________________________________________________ |
Grade: ____________ |
Title of project: ______________________________________ Date(s):___________________
Sponsoring Club/Organization: ___________________________________________________
Service Project Supervisor Name: _____________________ Phone Number: _______________
Social issue being address: ________________________________________________________
Description of Community Service Project:
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__________________________________ |
__________________________________ |
Student Signature |
Parent Signature |
__________________________________ |
__________________________________ |
Service Project Supervisor Signature |
Volunteer Service Coordinator Approval |
IB Students Only:
Please circle one: |
Creativity |
Action |
Service |
April, 2017
Community/Volunteer Service Project
Time Log and Evaluation
This log must be completed each day of participation in the Volunteer/Community Service Project. Time will not be included unless verified by the project supervisor as confirmed by initialing the form where indicated. This form may only be submitted at the completion of the project.
Activity/Service Performed
TOTAL Supervisor’s Initials
Evaluation—Please describe below what you learned from your volunteer service project:
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Total number of hours earned: ___________
__________________________________ |
__________________________________ |
Student Signature |
Parent Signature |
__________________________________ |
__________________________________ |
Service Project Supervisor Signature |
Volunteer Service Coordinator Approval |
April, 2017