Sweetwater Union High School Community Service Verification Form

It is a graduation requirement of the Sweetwater Union High School District that students complete 30 hours of community service work. Students are to keep accurate records of this work and complete this form for every submission of hours towards that requirement. Students should read this form carefully, obtain the necessary signatures, and then make a photocopy prior to submitting it to their Social Science Teacher. It is the student’s responsibility to document their hours well. Students need not submit hours after fulfilling the 30 hour requirement, but should keep a record on their own of all community service performed for college applications or scholarships they may apply to in the future.

REQUIREMENTS OF COMMUNITY SERVICE 1. Must be unpaid volunteer work (No pay must be received for service) 2. Must include parent and/or guardian’s signature for permission and approval 3. Must be pre-approved by the student’s social science teacher 4. Must be for a Non-Profit organization 5. No grades can be given for service (neither lowered, raised, nor as extra credit) 6. No family members may be the recipients or supervisors of service 7. No credit will be given during a student’s regular school hours 8. No credit will be given for extracurricular or co-curricular activities 9. No credit will be given for student aide activities 10. No credit will be given for court-required of other punitive service 11. Service work can be done with a religious organization to serve the community but not for a religious service or event (i.e. Feeding the Homeless with a Church group counts, but Altar Service or helping babysit for a Church service does not) 12. SUHSD Board Policy 0410 makes clear that all activities shall be free of discrimination based on gender, sex, race, ethnicity, religion, ancestry, national origin, ethnic group identification, marital or parental status, physical or mental disability, sexual orientation or the perception of one or more of such characteristics.

EXAMPLES OF COMMUNITY SERVICE . Tutoring afterschool at an elementary school . Helping at a hospital, convalescent home, or orphanage . Working for Habitat for Humanity, or a Non-Profit such as St. Vincent de Paul or the Salvation Army . Giving blood (2 hours of credit per donation) . Helping with a community team such as AYSO soccer or Little League . Helping remove graffiti off campus

STUDENT INFORMATION Student Name: ______Student ID #: ______School Name: ______

COMMUNITY SERVICE INFORMATION Name of Organization (Must be Non-Profit): ______Name of Supervisor: ______Position of Supervisor: ______Contact Phone Number and/or Email for Supervisor: ______Description of Community Service Work in one to two sentences:

SOCIAL SCIENCE TEACHER PRE-APPROVAL (If you complete hours without getting pre-approval, you take the risk that your teacher may not accept your hours as valid): Social Science Teacher: ______Social Science Teacher Pre-Approval: ______Date of Teacher Pre-Approval: ______Sweetwater Union High School Community Service Verification Form

PARENT PRE-APPROVAL I, parent/guardian of the above named student, give my permission for my son/daughter to participate in the community service activity described above: Parent/Guardian Pre-Approval: ______Date of Guardian Pre-Approval: ______

RECORD OF COMMUNITY SERVICE HOURS Please complete the following chart as a record of the hours you complete. If you run out of space, please attach a separate sheet with your additional hours and the information needed below in a chart such as this.

Date: (month-day-year) Time Number of Hours Supervisor Signature From _____ to ______

TOTAL HOURS: ______

POST COMMUNITY SERVICE STUDENT REFLECTION In one paragraph, please address the following: 1. Explain the purpose or mission statement of the organization you served. 2. How will your work benefit the community? 3. Reflect on how this work has affected you personally, including feeling about your work and yourself.

POST COMMUNITY SERVICE RECORD KEEPING Sweetwater Union High School Community Service Verification Form

Before giving this form to your teacher, be sure you have all the required signatures, and be sure you have a photocopy for your personal records. Your teacher will verify your hours and submit them to Chancery, then give the original of this form to the Counseling Center. Only originals of this form will be accepted.

Social Science Teacher Verification and Submission Signature: ______Date of Teacher Submission to Chancery: ______