COMMUNITY SERVICE VERIFICATION FORM All …

NO. grades can be given for SERVICE ; neither lowered, COMMUNITY SERVICE VERIFICATION form raised, or as extra credit. All COMMUNITY SERVICE Must Be Unpaid and Volunteer Work For details please refer to SUHSD COMMUNITY SERVICE Guidelines NO. pay may be received for SERVICE . Student Name: _____ ID #: _____. NO. School Name:_____ Social Science Teacher:_____ family members may be the recipients or supervisors of SERVICE . 1. To be completed BEFORE performance of the COMMUNITY SERVICE activity: NO. Description of COMMUNITY SERVICE : credit will be given for SERVICE during student's Name of Organization: _____ regular school hours. NO. Describe the COMMUNITY SERVICE Activity: _____ credit will be given for extracurricular (co- _____ curricular) activities or student aide activities. _____ NO. credit for SERVICE will be Parent/Guardian Permission: I, parent/guardian of the above-named student, give my permission recorded without a parent for my son/daughter to participate in the COMMUNITY SERVICE activity described below.

Revised Form - May 2013. COMMUNITY SERVICE VERIFICATION FORM All Community Service Must Be Unpaid and Volunteer Work NOFor details please refer to SUHSD Community Service Guidelines Student Name: _____ ID #: _____

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