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3575 Fieldgate Drive Mississauga, Ontario L4X 2J6

905-625-7731 www.glenforestlibrary.com

PLEASE MAKE SURE YOU HAVE DONE THE FOLLOWING BEFORE HANDING IN YOUR FORM:
Total your hours Show Completion Date

Parent/guardian signature

Keep a photocopy

___________________

_________________________________

Student Number

_______________

_______________________________________________

Student First Name

Student Last Name

______________________________________

Total Hours

____________________________________

Date Completed

Parent/Guardian Signature (Including students over 18)

*Attach ONE of the following to your volunteer form:


1) SUPERVISORS BUSINESS CARD

2) NOTE FROM YOUR SUPERVISOR ON ORGANIZATION LETTERHEAD

NAME THE ORGANIZATION you did your volunteer work for and describe (in detail) how your
activity contributed to the community.
Describe your activity in detail below Supervisors Official Title

Hours

________________

Completion
Date

3) YOUR TIME/LOG SHEET

Supervisor
Information

___________
Supervisor's Signature

______________
Supervisor's Name (Printed)

______________
Supervisor's Phone Number

Describe your activity in detail below Supervisors Official Title

________________

___________
Supervisor's Signature

______________
Supervisor's Name (Printed)

______________
Supervisor's Phone Number

Describe your activity in detail below Supervisors Official Title

________________

___________
Supervisor's Signature

______________
Supervisor's Name (Printed)

______________
Supervisor's Phone Number

OFFICE USE:

more info needed see principal a

pproved

Principal Signature (C. Horvath) ____________________________

PARTICIPATE
Offer the best
G:\Peros\Counseling\40 Hours\40 hours Form.doc

RESPECT
Expect the best

ACHIEVE
To be the best

Entered into SIS Init.

__________________

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