Report Your Community Service

If you participated in any school-related community service activities this month, please complete this survey to log your efforts and tell us about your experience.

School Name:

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* 1. School Name:

Legal first name of the student who participated in the service activity:
*Please note that name must match school enrollment information

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* 2. Legal first name of the student who participated in the service activity:
*Please note that name must match school enrollment information

Last name of student who participated in the service activity:
*Please note that name must match school enrollment information

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* 3. Last name of student who participated in the service activity:
*Please note that name must match school enrollment information

Please enter your student ID#:
*Please locate student ID number in "My Info" under the "school" tab

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* 4. Please enter your student ID#:
*Please locate student ID number in "My Info" under the "school" tab

Student Grade Level:

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* 5. Student Grade Level:

Month in which community service hours were completed:

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* 6. Month in which community service hours were completed:

Community Service Theme:

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* 7. Community Service Theme:

Number of service hours completed this month:

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* 8. Number of service hours completed this month:

Service venue name:

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* 9. Service venue name:

Service venue location (city name):

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* 10. Service venue location (city name):

Name of organization:

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* 11. Name of organization:

Description of Service Activity/ies:

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* 12. Description of Service Activity/ies:

Number of items you donated this month (if applicable):

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* 13. Number of items you donated this month (if applicable):

Total funds raised or money spent/donated this month (if applicable):

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* 14. Total funds raised or money spent/donated this month (if applicable):

Is there anything that you learned from completing this service activity?

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* 15. Is there anything that you learned from completing this service activity?

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