VOLUNTEER COMPLETION FORM

STUDENT INFORMATION:
Name: _______________________________________________________________
Student ID#: __________________________________________________________
Home Address: ________________________________________________________
______________________________________________________________________
Phone #: ______________________________________________________________
Email Address: _________________________________________________________
Academic year: __________________
ORGANIZATION INFORMATION:
Name of Organization/Agency: _____________________________________________
Name of Supervisor: _______________________________________________________
Address of Organization/Agency: ____________________________________________
Phone Number of Organization/Agency: ______________________________________
E-mail of Organization/Agency Contact: ______________________________________
Brief Description of community service performed:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Email Address: _____________________________________________________________

HOURS COMPLETED:

VOLUNTEER COMPLETION FORM

Date

HOURS

Task