2023.24 MERHS Community Service Form
Please fill out and submit this required form for each individual community service activity you have completed to ensure you are awarded credit for your community service hours. Be sure to talk with your school counselor to confirm your service hours for final approval.
Email *
Student Last Name *
Student First Name *
Class Year *
Name of community service organization and the activity completed: *
Briefly explain your role as a volunteer and your responsibilities.   *
Dates of Service
(If exact dates are unclear, please provide the month and the year, or the season and the year, such as "May 2022" or "fall 2023." 
 *
Total number of hours completed: *
IMPORTANT.
Please provide the name and phone number or email address of the contact person who can confirm the hours that you completed, or the person in charge of supervising volunteers. 
 *
What is the purpose/mission of the organization you served? *
Describe the type of event/activity for which you volunteered. *
How did your volunteer work help the community? *
What did you learn about this experience? *
Student (electronic) Signature *
Today's Date *
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A copy of your responses will be emailed to .
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