Graduation with Distinction Log

Student Name (please print): Class of 20

Organization/Project:

Description of Community Service:

Date Activity # of Hours

TOTAL HOURS =

*All community service hours must be returned within 45 days of the start of an activity.

I verify that I have completed and was ACTIVELY involved in the community service listed above.

Student Signature Date

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I verify that the above named student completed community service during the hours described above and that he/she was
ACTIVELY involved in the service described.

Volunteer Coordinator (please print) Volunteer Coordinator Signature Date

Organization Job Title/Position Phone Number

Revised 6.14.17