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South Shore Charter Public School Community Service Form - Level III
Please be sure you fill out this form for each community service opportunity you complete
One form per session must be completed for community service hours
You will receive a copy of your submission via email
Level III students are required to complete 15 hours of community service by June 1, 2024
Community service opportunities are listed every week in the Weekly Update and on our
website
Questions regarding what constitutes community service, please see JP or your teacher for clarification
Thank you for making a difference. Your work is appreciated!
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* Indicates required question
Email
*
Your email
Student Name
*
Your answer
Student Grade
*
Choose
Grade 5
Grade 6
Community Service Hours/Days Completed
*
Your answer
Community Service Organization
*
Your answer
Site Supervisor Name
*
Your answer
Site Supervisor Email
*
Your answer
Please write a paragraph describing the service work you did and what you learned from the experience.
*
Your answer
Student Verification
*
By checking this box I verify that the information contained herein is true and accurate.
Required
Parent/GuardianVerification
*
By checking this box I verify that the information provided by my child is true and accurate.
Required
A copy of your responses will be emailed to the address you provided.
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