FRIENDSWOOD

CHAPTER

of
NATIONAL HONOR SOCITETY
Service Hour Form
Name: ___________________________________________ (please print) Grade: ___________
**ALL NATIONAL HONOR SOCIETY MEMBERS MUST HAVE THIS FORM
FILLED OUT COMPLETELY IN ORDER TO RECEIVE HOURS! **
**PLEASE PRINT CLEARLY**
Organization: ________________________________________ Time Service Began: ________
Location of Service: ___________________________________Time Service Ended: ________

Date(s) of
Service

Explanation of Activity

Total # of
Hours

____/_____/____ _________________________________________________________
____/_____/____ _________________________________________________________
____/____/_____ _________________________________________________________
____/____/_____
Supervisors Name (please print): _______________________________________ (cannot be
your parent)
Supervisors Email Address: _______________________________________________________
Supervisors Phone Number: ______________________________________________________
Supervisors Signature: ________________________________________ Date: ___/____/____
Your Signature: _____________________________________________ Date: ___/_____/____
Is a letter of verification stating that you completed the following community service hours from your
supervisor included?

YES

NO

If yes, then please staple the letter to this service hour form.

Officer use only:

Received: ____/_____/____ Initials: _______