Eaglecrest Honors Diploma Community Service Form

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Welcome! This form must be completed within one month of the last date of service. Please contact Ms. Sunita if you have any questions.

Community Service Mission Statement:
The Community Service Program at Eaglecrest High School connects our students to local, national or international communities in need through sustained, meaning relationship. This work broadens student horizons and makes the world a better place.

Signature Line (Last, First) *

By typing my name below, I certify that the information I complete in this form is true and accurate. I also confirm my understanding that providing any false information is a violation of Eaglecrest High School's Raptor Way and would subject me to disciplinary action by the school.

Class of: *

2024

2025

2026

2027

Date(s) of Service *

format: month/date/year (example: 12/3/2013-12/7/2013)

Hours Worked *

Enter a number only. Use .25 for each quarter of an hour.

Name of Supervisor *

Phone Number of Supervisor *

Email of Supervisor *

Would you recommend this organization to another student at Eaglecrest High School? Why or Why Not.

*This question only applies to community service hours completed through organizations not related to Eaglecrest.

Identify the category need that was being serviced by your time and effort *

Commitment to children and young people – Mentoring, foster care, youth and community recreation programs, youth and peer counseling, church community service projects.

Helping others learn – Tutoring, library development and assistance, Big Brothers or Sisters projects, teaching special learners.

Health care and sense of well-being – Services to the elderly, homebound, or those with special needs, hospital assistance, meal preparation, walk, jog, or bike-thons for special causes, snow removal, yard work or errands for physically unable personals, homeless shelters, animal shelters, food banks, drug awareness and prevention programs, crisis and help lines.

Environment – Recycling programs, neighborhood clean-ups, school programs, Habitat for Humanity, environmental groups and campaigns.

Community awareness – Elections and campaign activities, fundraisers for service organizations, hosting foreign or special guests, participation in regional or national conferences for youth and education, job shadowing, career exploration.

Cultural Experience (International Studies)

Did you participate, lead an activity, or develop the overall community service activity? *

Participant

Leader of an Activity

Developed the community service project

What duties did you perform while working with this organization? *

Reflect upon your community service experience. *

You may choose from one of the following prompts or write your own thoughts. In what way did you work to improve the situation of this community and what progress did you make toward this end? What did you learn while volunteering with this organization? What sort of personal growth did you experience during your time with the organization? What was your favorite or least favorite part of the experience? Explain what made it so.

Student email address *

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