Volunteer Hours Collection Form

Each family receiving financial assistance this school year was required to complete a minimum of 20 hours (10 hours for single parent households) during the school year.

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* 1. Contact Information:

Name

Email Address

Phone Number

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* 2. Total hours completed by your immediate family members to date:

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* 3. Please list your volunteer activities and dates completed.:

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* 4. First and last name of your student: