Eastlake High School Service Worksheet
Students must complete at least 20 hours of volunteer service their sophomore and junior year at EHS. They are required to turn this form in to their advisor for each service activity completed.
o Must receive a signature from someone in charge of the service activity
o Cannot receive compensation or a grade for the service
o Cannot be mandatory service, required by school, county, or state
o Cannot be service for a relative
Student Name: ________________________ Grade: ________
Advisor Name ____________________
Address (e-mail or postal): _______________________________________________________________
Supervisor Name and Title: ___________________________________
Date of service: ___________
Supervisor Signature: ____________________________
Hours Volunteered: ___________________
Student Signature: ______________________
PREPARATION and ACTION:
What did you do? Why? Who did you serve? Where? When?
REFLECTION and DEMONSTRATION:
Describe the significance of the community service you did. What impact did it have on you personally? On the person/group for whom you worked? On the community at large?