PARTNERS IN EDUCATION (PIE)

VOLUNTEER SERVICE FORM

Volunteer service is any activity that is for the benefit of an individual or organization where the
student is not paid for the service. Acceptable activities include, but are not limited to: church mission
trips, scouting community service projects, club community service activities, etc. Service performed
for family members/family business is excluded. Club meetings should not be included as volunteer
hours.

PIE recognizes students who are volunteered 50+, 100+, 200+, and 400+ hours. A PIE volunteer
keeps track of the volunteer hours and provides a summary upon request through Student Services.
Hours are tracked for the entire high school career.

Student’s Name: _______________________________ Date: ___________________________

Student ID #: __________________________ Year of Graduation: _________________________

Service Organization: __________________________________________

Service Organization Contact: __________________________________________

Service Organization Address: __________________________________________

__________________________________________

Total Hours Worked: _______________ Service Date(s): _________________________________

Description of Service Performed: _____________________________________________________

To be completed by the Service Organization (Cannot be related to the student.)

How did this student benefit your organization? __________________________________________

Signature of Service Organization Contact: ___________________________________

Return completed form to Student Services.