Community Service Log Question Title * 1. Today's Date Today's Date Date Question Title * 2. Debutante Candidate's Name and Contact Information Name (First and Last) Email Address Phone Number Question Title * 3. Debutante Candidate's Parent or Guardian's Name and Contact Information Parent or Guardian Name (First and Last) Email Address Phone Number Question Title * 4. Name of Agency/Facility and Contact Information Where Your Volunteered Agency's Contact Person Who Can Verify Your Hours (First/Last) * Agency/Facility Name * Address * Address 2 City/Town * State/Province * ZIP/Postal Code * Email Address (if known) * Agency Phone Number * Question Title * 5. Voluntary Activity Question Title * 6. Volunteer Date Volunteer Date Date Question Title * 7. Number of Volunteer Hours (enter time in 15 minute increments and only include numbers; for example, 3 hours = 3.00; 3 hours and 15 minutes = 3.25; 3 hours and 30 minutes = 3.5; 3 hours and 45 minutes = 3.75) Question Title * 8. Responsibilities Done