Community Service Verification Form

All community service must be unpaid volunteer work.

Monarch High School seniors must complete a total of thirty (30) hours of community service as part of the
Senior Portfolio graduation requirement.
● Ten (10) hours due by March 2, 2020.
● Twenty (20) total hours due by April 6, 2020.
● All hours must be completed by May 4, 2020.
● A maximum of ten (10) hours may be completed on campus at Monarch.

To be completed BEFORE the performance of the community service activity:

Name of Organization: ____​Boy’s To Men Mentoring​_______________________________

Description of Community Service Work: _​Spend Weekend Helping out with tasks and chores, Attending
weekly meeting​________________
____________________________________________________________________________________________________

Dates When the Above-Described Community Service Took Place and Validating Signatures:

Date and Time # of Hours Supervisor’s Signature, Position, and Phone Number

2016 - 2019 98 Hours Jose Garcia​, Youth Coordinator, (619) 469-9599

TOTAL # OF HOURS:___​98​___

Examples of Possible Community Service Activities:

● Assisting at Boys and Girls Clubs
● Working with Habitat for Humanity
● Tutoring after school at an elementary school
● Helping remove graffiti—off campus
● Helping at a hospital, convalescent home, or orphanage
● Working with community theater
● Helping with a community team such as AYSO soccer or Little League (helping with sports events of younger
children, refereeing, etc.)
● Helping at a non-profit organization such as St. Vincent de Paul, Salvation Army, etc.
● Donating blood (2 hours of credit each time blood is given)
● Helping at a Key Club or community event
● Helping the community through church-related activities
  
Student must complete the reverse side of this form after completing the community service activity.
  

Community Service Reflection

Explain the purpose (mission statement) of the organization you served:
Boys to Men Mentoring is a nonprofit organization committed to creating communities of empowerment for
all teenage boys on their journey to manhood _______________________________________________________
__________________________________________________________________________________________________

How did (or will) your work benefit the community?

The work I did created a safe environment for young boys in our community​.______________________________
____________________________________________________________________________________________________
_________________________________________________________________________________________________
Reflect on how you felt about your service and yourself:
I am proud of work I did to help create that safe environment for young boys in my community where they
wouldn’t have anywhere else to go. I want to contribute more to my community and my society, I am not sure
to do that yet but I am going to continue my work at Boys To
Men.________________________________________
____________________________________________________________________________________________________

Student Signature: _______​Billy Campos​___________________

Date:_____________________
  

Community Service Log

Use this chart to provide a summary of all community service activities you participated in this
school year. As a reminder, every senior must show evidence of completing at least 30 hours of
community service in their Senior Portfolio. This log is due by Monday, May 4, 2020.

Verified?
Date Name of Organization or Activity # of Hours
(Y/N)

Total Hours