#4 18 PRINT: SERVICE LEARNING LOG EDU 201, EDU 202, EDU 203 Participation Log: Complete (Combine) Service Learning components to equal 10 hours or more. Be sure to attach specific additional documents required for each type of service listed below. + Community Service: CCompanentin which the student works ina volunteer Ccapacty at any organization that willow volunteers, ‘and that serves th betterment of school age ehileron inthe community. This aganey is onein whieh the student sols and can obtain a verified etter of Paticipation or certticate fom the organization's Ieadorhip that documents ther patcipation and hours of rect once completed, + Private School Service: ‘The student must arange contact and obtain wren permission trom the schoo! admiration prior to Vistation, and must have an offcer ofthe school provide signed veriicaton upon schoo letteread of the typ0 of so-vo® promod, ans raton cf ha communty servcote meter, + Organized Field Trip: Your CSN instructor may be abe to organize an education based ted tp in which al members of the class moot at nother location, istead of attencing class atthe regular scheduled time to ean service credit. Students must fil ‘out CSN's Fed Trip Waiver and provide ito the instructor ‘fore raving toa sponsored of-campus event, Crect outs and vertication fr this experience willbe determing by your instructor + Other Service ‘The student can dsign and presenta unique service orienta educational experience to their instructor, “The proposal must be in wing and agreed upon by the CSN student and CSN instructor porto ‘accumulation of hous. YOU MAY NOT ist the school you chose for your Field Oueervaton raquest, or anyother CCSO schoo! as the agency for his Serce Leaning Proposal. Why? First of al the 10 hours tor Fels Ouseration is independent of the 10hours serving the community at anather agency. ‘Second, you nave no idea what scneol you wil eventually 'be place at tis te. Lastly, your eventual cooperating teacher may not give you peission to stay an extra 10 outs beyond the requirements of tha Feld Observation, ‘The 10 nours of Communty Serve isnot related tothe 10 hours of CCSD Fld Observation, so DO NOT stat cold ‘cling any CCSD soho to ask permission to vokteer ther, Your Full Name (pring: HeleM A. OTTEGA 03 Church worship Aceney/Iype of Service: Date(s) 2-21-18 Cur. Bd mins) Date(s) 03-04-18 (Whrs Date(s) 3-07-16 Cine zum.) Total Hours ‘Supervisor Name (print ‘Supervisor Signature: ‘Supervisor Phone: ‘Supervisor e-mail: ‘Agency/Type of Service: C3 _Churen Wwshi Date(s) ~ on- 18 (Lr. 30M Date(s) - Date(s) ‘Total Hours: ‘Supervisor Name (print): ‘Supervisor Signature: ‘Supervisor Phone: ‘Supervisor e-mail: Agenoy/Type of Service: Date(s) Date(s) Date(s) ‘Total Hours: ‘Supervisor Name (print ‘Supervisor Signature: ‘Supervisor Phone: ‘Supervisor e-mall