Community Service Hours Submission Form
Page 1 of 1
Mendon High School
Sutherland High School
Barker Road Middle School
Calkins Road Middle School
I will graduate high school in the year of:
Total Number of Hours
Enter date(s) and hours for EACH day. For example: 1/4/20xx 2 hrs; 2/17/20xx 5 hrs. For extended dates, use timesheet, attach to form and write see attached.
Describe what you did
What did you learn from this experience?
Parent Signature (10 HOURS or less)/Supervisor Signature (Over 10 Hours) NOTE: LEAVE BOX EMPTY AND OBTAIN HANDWRITTEN SIGNATURE HERE ON PRINTED FORM:
I understand this is NOT an online process. I need to print this form (AFTER CLICKING DONE), obtain signature and turn in to the community service office for credit.