National Honor Society Volunteer Log 2016-2017

***Due to Ms. Geldersma by May 1, 2017***

Name ________________________________________________ Grade __________

Service Hours Advisor/ Coach/adult Contact Information (Phone num

supervisor's Name email) of the person listed in co

* Please attach any additional volunteer hours to another volunteer form.

___________________________________________________________________
Print one of the advisor/coach/adult supervisor's name from column 3 here

_______________________________________________________________________
Contact Information of the person listed above

_______________________________________________________________________
Signature of the person listed above Date

I, _____________________________________, verify my participation in the above

stated volunteer activities. I also understand that if this information is proven to be
false, I will not be able to count these hours toward my NHS requirements and
further disciplinary actions may be taken.