SJCA Upper Campus Student Service Hours Form
All SJCA Upper Campus students are required to complete annual service hours. 

* Middle School students are required to complete 20 service hours per year.
* High School students are required to complete 25 service hours per year. 

Please complete the form below to document service hours that you have completed. 

Please complete this form after each service activity to assist in keeping service records current.

Each student must submit his/her own service hours forms. Please note: One form may not be used as a submission for multiple students.

Thank you.
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Email *
Student's name
 *
Student's grade *
Name of the service activity *
Date of the service activity *
Location of the service activity *
Duration of service activity (e.g., 1/2 hour, 1 hour, 2 hours, etc.) *
Name of adult supervising the activity *
Contact info (phone or email) for the adult supervisor 
Description of the service that you completed. *
Please provide a brief reflection on your service activity.
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