JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Community Service Verification Form
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Community service is volunteering your time without pay to worthy causes within the Warroad area community.
Click here for a list of
community service facts, tips, rules, and approved civic organizations
.
Instructions:
1. Please complete and submit the form below.
2. Maintain a copy for your files to use as a reference during the scholarship application process.
Student First Name
*
Your answer
Student Last Name
*
Your answer
Graduation Year
*
Your answer
Organization Community Service was Performed for
*
Your answer
Date(s) of Community Service
*
If your community service was done over multiple days, please list all the dates below
Your answer
Detailed Description of Services Performed
*
Your answer
Total Number of Hours Volunteered
*
Your answer
Adult Contact #1: Name
*
This contact must be able to verify that the above hours and services were done under their supervision and were done on a volunteer basis with no pay. The contact cannot be a relative.
Your answer
Adult Contact #1: Phone
*
Your answer
Adult Contact #1: Email
*
Your answer
Adult Contact #2: Name (Optional)
This contact must be able to verify that the above hours and services were done under their supervision and were done on a volunteer basis with no pay.
Your answer
Adult Contact #2: Phone (Optional)
Your answer
Adult Contact #2: Email (Optional)
Your answer
By submitting this form, you are approving the accuracy of this entry.
The submitted information will be verified and any false information reported may result in your ineligibility for scholarships.
Thank you for your service!
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Warroad Public Schools.
Report Abuse
Forms
