CHERYL ROSEVEAR COMMUNITY SERVICE             SCHOLARSHIP REFERENCE FORM
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                                                     TRI-CREEK EDUCATION FOUNDATION, INC.
COMMUNITY SERVICE VERIFICATION FORM 2024
The following form is to be completed by a contact person at the organization for whom the community service was performed. If multiple organizations are involved, please provide each additional organization with a copy of this form for their convenience.
This form should be submitted no later than 3 PM on Friday March 1,2024
All community service listed below must be voluntary and non-compensated.
Student First Name *
Student Last Name *
Organization Name: *
Organization Address: *
Organization City: *
Organization State: *
Organization Zip Code: *
Organization Phone Number: *
Organization Email: *
Community Organization Contact Information
Name of Person completing this form and position: *
Brief description of community service performed by student: *
Dates of Service: *
Total Hours of Service: *
In your opinion; what qualities did this student exhibit, while performing community service, that you feel entitles him/her to be considered for this scholarship? *
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