Family Service Hours

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*Must be VIRTUS cleared to work directly with children
*You must include the name of the chair/co-chair/staff member in charge of the event
*Each family must have 20 completed service hours by May 31, 2024
*Families will be billed $50 for each uncompleted MANDATORY service hour and $25 for each uncompleted nonmandatory service (see handbook)

*Only hours submitted on this form will be accepted

Email *

Parent/Guardian Name *

Student Last Name *

YOUNGEST Student's First Name *

Grade of YOUNGEST Student *

Pre-Kindergarten

Kindergarten

First Grade

Second Grade

Third Grade

Fourth Grade

Fifth Grade

Sixth Grade

Seventh Grade

Eighth Grade

Service Completed *

Date Service Completed *

YYYY

Chair/Co-Chair/Faculty Sponsor's Name *

Number of Hours Completed *

A copy of your responses will be emailed to the address you provided.

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