Polk County Public Schools COMMUNITY SERVICE PROGRAM RECORD OF VOLUNTEER SERVICE HOURS MAXIMUM NUMBER OF HOURS ACCEPTED PER DAY IS 8 (EIGHT) Student Name: ID# Class of: Contact Agency Activity Time Time Total Person’s Date Name Performed In Out Hours Signature Total Hours Volunteered: Service Organization Name: ____________________________________________________ Service Supervisor Name: _______________________________________________________ Service Supervisor Signature: ____________________________________________________
Polk County Public Schools COMMUNITY SERVICE PROGRAM RECORD OF VOLUNTEER SERVICE HOURS MAXIMUM NUMBER OF HOURS ACCEPTED PER DAY IS 8 (EIGHT) Student Name: ID# Class of: Date Agency Name Activity Performed Time In Time Out Total Hours Contact Person’s Signature Total Hours Volunteered: Service Organization Name: ____________________________________________________ Service Supervisor Name: _______________________________________________________ Service Supervisor Signature: ____________________________________________________
Polk-County-Schools-Community-Service-Hours-Form.docx