HOUSTON CHRISTIAN HIGH SCHOOL Community Service Form 20112012
For even the Son of Man did not come to be served, but to serve … Mark 10:45 SERVICE MUST BE COMPLETED ACCORDING TO THE GUIDELINES ON THE BACK OF THIS FORM. FORM MUST BE COMPLETE TO RECEIVE CREDIT.
Student Name __________________________________Block_______ Grade _______ 9 Weeks 1 2 3 4 For DONATION, answer questions below. Name of Group Who Received Donation _________________________________________________________ $ Amount of Donation _________ or Item(s) Donated (attach receipt) _________________________________ Date of Donation _______________________ Hours Earned from Donation_____________________________ What did you learn from this service experience?____________________________________________________ ____________________________________________________________________________________________ Impact this service has/will have on the community.________________________________________________ ____________________________________________________________________________________________ What challenges did you face?________________________________________________________________ ____________________________________________________________________________________________ HOW does this community service tie into what you have studied/are studying in Bible class or your faith? ____________________________________________________________________________________________ ____________________________________________________________________________________________ For ACTUAL HOURS WORKED, answer questions below. Name of Place Worked _________________________________________Date(s) Worked__________________ Actual Times Worked ________ a.m./p.m. to ________ a.m./p.m. Total Hours Worked _________________ Description of work you did___________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ What did you learn from this service experience?__________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ Impact this service has/will have on the community________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ What challenges did you face?________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ HOW does this community service tie into what you have studied/are studying in Bible class or your faith? ____________________________________________________________________________________________ ____________________________________________________________________________________________ Verification of my service by: Name ____________________________________________________ Date________________________ Adult Signature ____________________________________________ Phone_______________________