NHS Community Service Form

for_________________________ (fill in your name)

Members are required to turn in the appropriate amount of service hours on each due date as determined by the executive board and adviser(s). Summer hours are due prior to October 1.

Only recognized established institutions and organizations are approved as sites for community service (i.e. grade schools, libraries hospitals, nursing homes, churches, social service agencies, community service groups etc.). The following will not be approved: doing chores like mowing lawns, baby sitting, shoveling snow for neighbors or friends; working for your parents for free; donating time at a for-profit business; tutoring in an unstructured situation. These community service hours must be over and above those performed for any of your school related activities.

Date of service	Number of hours	Organization/ Service performed	Authorizing signature and title	Phone #

Do not hold this form until you have completed all of your hours for the term. Report your service hours as you complete them. Turn in this form at the media center.