NHS Service Project: Student Form

First: Type all of your information into this form and answer the questions completely.
Next: Print it and sign it once it's completed.
Then: Bring it to your contact person to have them complete the bottom of the form.
Finally: Turn the form in to Mr. Aiello by the due date. No late forms are accepted.

Student Name:           Grade: Junior        Senior

Service Category: Environment         Children & Schools         Elderly & Sick         Less Fortunate

Name of Organization:

Contact Person:            Phone Number:

Type in the dates and number of hours for your service project and then explain what you did during this service project, and how this benefited the people in the community.

Date
Hours
 


Student Signature __________________________________________________       Date: __________________________

 

For the contact person:

1) Did the NHS student named on this form act appropriately during his/her service time?
     Not at All     Sometimes           Most of the Time     Always

2) Did the NHS student named on this form arrive when expected and stay until dismissed?
    Not at All     Sometimes           Most of the Time     Always

3) Did the NHS student named on this form complete tasks appropriately?
    Not at All     Sometimes           Most of the Time     Always

 

Contact Signature _______________________________________________             Date: __________________________  

May I use your organizations contact information on a school web site that directs other Shorewood students to community service opportunities?

    Yes     No      If yes, please check that the information typed by the student at the top of the form is correct.

If you have had any questions or problems contact me directly at baiello@shorewood.k12.wi.us or (414)-963-6920
Brett Aiello (Shorewood NHS Advisor)