Post on 29-Jun-2015
description
MT. PLEASANT CHAPTER OF NATIONAL HONOR SOCIETY
Community Service Project Report Form
Directions: This is the community service project report form for the Mt. Pleasant Chapter of the National Honor Society. Please complete all sections by our first meeting of the second semester which will be dated. You are welcome to submit it in to Mrs. Cocovich in room 1202 beforehand.
I. Member Information (Please type or print):
Name: _______________________________
Student ID#: __________________________
E-Mail: _________________________________
Phone Number: ___________________________
II. Community Service Project
Name of project: _____________________________________________________________________
(Brief Description):
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
When did you begin? (mm/yyyy)
_____________________________________
Total Hours (to date):
_____________________________________
Hours per week:
_____________________________________
Supervisor’s Signature:
_____________________________________
I affirm that all information in this form is true, complete, and answered to the best of my ability. Any misinterpretation, false statement, or omission of facts shall be grounds for punishment.
Applicant’s signature and date:
Name:______________________________________________ Date: _____________________________