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Citizenship Service Project Verification Oconomowoc High School Contact Brad Ducklow at 262-560-3100 ext. 3214 or email at Brad.Ducklow@mail.oasd.k12.

.wi THIS PART IS TO BE FILLED OUT BY THE STUDENT


Student Name:

Agency or Organization

Contact Person at Agency or Organization & Title

Location of Project

Description of ProjectDescribe what the project was and how you feel it reflected citizenship

Date(s) and Times Service Performed

THIS PART TO BE FILLED OUT BY BUSINESS CONTACT PERSON


This volunteer work was over and above any volunteer work done for other classes, youth groups, clubs, church groups, or other organizations.

The student performed

hours of service work as described above.

Name (PRINT) _____________________________________________

Signature

_____________________________________________

Daytime Phone _______________________________

Date ___________

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