University of Puerto Rico at Ponce

English Department
ENGL 4021

Service Log

Name: _______________________________ Course Section: __________

Group/Team: ________________

Selected service site:

___________________________________________________________
_________________________________________________________

Tasks performed:

___ 1. Planting/Plowing DATES: # Hours: Initials:

______________________________
___ 2. Composting
______________________________
___ 3. Cleaning garden, removing weeds ______________________________
______________________________
___ 4. Creating seedlings ______________________________
___ 5. Painting or building ______________________________

___ 6. Watering
___ 7. Sowing
___ 8. Other Specify: __________________________________

Contribution /Donation (optional):

_______________________________________________________________

CERTIFICATION

I hereby certify that__________________________ completed ______hours

name of student #
of service at _____________________________________________________
name of farm or urban garden

Supervisor’s signature: __________________________ Date: _____________

PRINTED NAME: __________________________________
 University of Puerto Rico at Ponce
English Department
ENGL 4021

Service Log

Name: _______________________________ Course Section: __________

Group/Team: ________________

Selected service site:

___________________________________________________________
_________________________________________________________

Tasks performed:

___ 1. Planting/Plowing DATES: # Hours: Initials:

______________________________
___ 2. Composting
______________________________
___ 3. Cleaning garden, removing weeds ______________________________
______________________________
___ 4. Creating seedlings ______________________________
___ 5. Painting or building ______________________________

___ 6. Watering
___ 7. Sowing
___ 8. Other Specify: __________________________________

Contribution /Donation (optional):

_______________________________________________________________

CERTIFICATION

I hereby certify that__________________________ completed ______hours

name of student #
of service at _____________________________________________________
name of farm or urban garden

Supervisor’s signature: __________________________ Date: _____________

PRINTED NAME: __________________________________