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Community Involvement Activity Notification and …

E16(CommunityInvolvement2014)smac1515 High School _____ Community Involvement Activity Notification and completion form Students are encouraged to begin their Community hours in the summer preceding entry into Grade 9. Date submitted: _____ Last Name: _____ First Name: _____ Trillium # _____ (yyyy-mm-dd) Date Hours Completed Organization Description of Activity Supervisor s Name and Phone Number Supervisor s Signature Principal s/Designate s Signature (*if required) Total Hours I acknowledge that I am responsible for the monitoring and safety of my son/daughter during the completion of these hours.

E16(CommunityInvolvement2014)smac1515 High School _____ Community Involvement Activity Notification and Completion Form Students are encouraged to begin their community hours in the summer preceding entry into Grade 9.

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