Location: BEIT North Pecos Ra, Las Voges, NVSOI15 Pax (702) 384-1951 peiy Mission of Las Vegas edge any Hen sh Hoes Ofing Hep no’ Nes (702) 384-1990, + Community Service: Component in which he eudert works ina vontaer ‘apacty et any eraniztion hat wt alow volar, that ‘sere he Detirant of sche age cir ne ‘communi end on nic he Student can obi & ‘vere letar of partpation o certificate from the ‘orgenization's leadership documenting peiciptin and hours of ert + Private School Service: “Te udent must obtain weten permission rom ine schools admin pri to stator ard must have an ‘of of he school poi saned verieation upon schoo! letetnead ofthe typeof end duration ofthe eerdce. + Organized Field Trip: Your C3Minsructr ay b abla to orice an eduoton ‘based itd tpn wich a members fhe aes meet at ‘nother loeton, stead of atencng cas a there Schedles, Stents must fot CSN Feld Tp Waiver and prove to tn nerctr bore traaing to ano (carpus overt Cc hours and varfeaton fer ts experience it be determined by your sri. + Schoo! Volunteer: ‘The student may range a volts experienc tay schoo! ‘iin rir sen escent! tondance Dourdan, The goa er thi sere isa the student the opperuntyt volar a comeelaly cern esscatonal eng or capac thn they ware fssgneddutg tha 10 our Fed Obsovation, For intone, ‘Somoone wating ofeach a th aconday lve wo wae cae {ra gh aoa for thle 10 Hou Fld Observation, sy cose to doa prion of ter Senoe Laing Component tthe ow ha elementary achoan some sor of vole capaci. \erestion of hours and evel of participation wil be provided In writen form on schoo ltterhoad by the CCSD intructer, ‘choo! adninitatr or schoo organization’ leadership, + Additional patiipation a school assigned by (CCSD during Field Observation: if CSN sudent and signed COSD cooperating teacer fies. a stdert san serpy cheoea arena at te assigned ‘cho! and classroom beyond he mandetoy 10 hous of ald CCbeervton, end continue ccumctng up o 10 addtional urea he ste, The student and coopersing teacher ae neouraged to increase the vel of civ parton bythe CaN student beyond impo pastive observation + Other Service “a sucent can design and presenta deen service eal edveatona exarione to hentia. The proposal must be in writing ana groed upon bythe CSN ‘student and CSN inerctor rt scumdation of hours. Linda Clark tarning LOg (10 Hours) . omnes] OReeHemeer TF QO], EDU 202, EDU 208 Mailing: PO, Box 94179, North Las Vegas, NV 50006, Learning Choices to equal 10 hours or more. documents required for each type of service listed below. jdocuments required for each type of service listed below. Your Full Name (print: Derrick DeLuca Agency/Type of Service: < x Ban N: Pecos ATE Date(s) LLG 12 = Y ages BAT Date(s) rae Bs Date(s) LL Do~/2 = Yue s Total Hours: Zo ue Supervisor Name (print): Supervisor Sign Supervisor Lenz Supenisor e-mail: Lada Cine mor 2 Aol. SSS Agencytype ot Service: _O.k. Aebcock ES Date(s) fe a Date(s) wf22 Le Date(s) W130 [te Total Hours: YO Supervisor Name (prin: _ Azusa Aycoct ‘Supervisor Signature: Pee Aa ‘Supervisor Phone: 02. 2 ‘Supervisor e-mail: 2 intes ccs. ek Agency/Type of Service: Date(s) Date(s) Date(s) ‘Supervisor Name (print): Supervisor Signature: ‘Supervisor Phone: ‘Supervisor e-mail: Ta Total Hours: ——— ao| three ft square: acc — Famke Wali Faroe fake tie, ‘las Concession Group Dina espe, Parag Smiog Luc ‘Shae Mates In Sine Food & rug Stores, ne. SNOspore {Conrsa'N Hiton Foundation ‘MM Resor internation ist sty Fe rately reelisy Compeny ot ath fe Marzi Comment Oeonieer Fram hor Esecars Eertainemant ‘The Coemapatan of Lae ages Bose Mekinney aes Energy Wee nesting Spats Witmer LLP Soarinn Sotthwett Sue Corporati en SBS utr 8 St ‘he er Chartabe Tas Presse C=O Et Opening otic ‘hier Franc tier atte loon het Beveapment cer 390. Pecos Rt, Las Vegas, NV89115, December 4, 2012 To Whom It May Concern: ‘This letter will confirm Derrick Deluca completed 12 hours of community service with City Mission of Las Vegas, one of the Agency Partners of Three Square Food Bank If you need further information or confirmation on Derrick’s volunteer hours, please feel free to contact me at 702-644-FOOD (3663), ext. 323 Our Employer Identification Number is 30-0396918, Thank you. Sincerely, Lil, imes L. Ray, Jr. Volunteer Coordinator Three Square Food Bank [ wwwetneeesquareorg E72 644-FoOD mui 702 245-45hy three Tt) square” 7 a CITY MISSION Date 2.2% <2 Deru Delve, Lott pas of - Meow i Decree Deluce Lote AP Lacie a OEN = a LZ. =ey 5q oe CITY MISSION Date VOLUNTEERS (Please Print) Time In - Tim: DenicK Deluca