SERVICE LEARNING /VOLUNTEER TIME SHEET

Please complete this form, print, and submit to record each of your Service Learning activities at CSU. IF YOU ARE SERVING AS AN INDIVIDUAL, PLEASE SEE BRITTANY PACK FOR SITE APPROVAL BEFORE YOU BEGIN, AmeriCorps Vista/Service Learning Office, Brewer Center (843) 863-7278.

Student Information

Student Information Student Name:
Student Organization (If Applicable):
Student ID #:
Cell Phone:
CSU E-mail address: (@csustudent.net):
CSU Major:
Expected Graduation Date (MM/YY):

Activity Information:

Activity Information: Type of Service (Service Learning or Volunteer):
Service Site:
Event:

Enter your start and end times for each date:

	MM		DD		YYYY	HH		MM	AM/PM
Start	Enter your start and end times for each date: Start Month	/	Day	/	Year	Hour	:	Minute	AM or PM
End	End Month	/	Day	/	Year	Hour	:	Minute	AM or PM
Start	Start Month	/	Day	/	Year	Hour	:	Minute	AM or PM
End	End Month	/	Day	/	Year	Hour	:	Minute	AM or PM
Start	Start Month	/	Day	/	Year	Hour	:	Minute	AM or PM
End	End Month	/	Day	/	Year	Hour	:	Minute	AM or PM

Enter your start and end times for each date:

	MM		DD		YYYY	HH		MM	AM/PM
Start	Enter your start and end times for each date: Start Month	/	Day	/	Year	Hour	:	Minute	AM or PM
End	End Month	/	Day	/	Year	Hour	:	Minute	AM or PM
Start	Start Month	/	Day	/	Year	Hour	:	Minute	AM or PM
End	End Month	/	Day	/	Year	Hour	:	Minute	AM or PM
Start	Start Month	/	Day	/	Year	Hour	:	Minute	AM or PM
End	End Month	/	Day	/	Year	Hour	:	Minute	AM or PM

Total Service Hours:

Please provide contact information for your site supervisor.

Please provide contact information for your site supervisor. Name:
Title:
Phone:
E-mail:
Supervisor Signature: