2022- 2023 Completed Service Activity Log
Use this form to enter each service as learning activity you have completed this year.  You must complete each required question to get full credit for your service.  
Sign in to Google to save your progress. Learn more
Student Last Name *
Student First Name *
Student's Grade Level
Clear selection
Date Activity was completed (month, day and year) *
MM
/
DD
/
YYYY
Number of hours spent completing service *
Type of service as learning you participated in *
Was this activity done independently or in a collaborative group/setting?  If collaborative, who did you work with?   *
Describe the service you provided.  What did you do?  Where did you do it?  Be specific. *
Which learner profile traits did you use well while completing this service? *
Required
What challenges did you experience during this service as learning activity?   *
As you reflect, what can you do in the future to ease the challenge you described above when you participate in new service as learning events?   *
What impact did your service have on the community you interacted with?  *
What impact did completing this service have on you?  Did your mindset change?  Did you learn something new?  Do you have a new perspective? *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Charlotte Mecklenburg Schools. Report Abuse
Google Forms