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Lake Washington School District
Eastlake High School
400 228th Ave. N.E., Sammamish, WA 98074 | 425 936-1500
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Eastlake High > For Students > Community Service Form
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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.

Guidelines:
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 ____________________


Organization/Name: _____________________________________

Telephone: _____________________


Address (e-mail or postal): _______________________________________________________________


Supervisor Name and Title: ___________________________________

Date of service: ___________


Supervisor Signature: ____________________________

Hours Volunteered: ___________________


Student Signature: ______________________

Parent/Guardian 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?