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MT. PLEASANT CHAPTER OF NATIONAL HONOR SOCIETY

                                    Community Service Project Report Form

  Directions: This is the community service project report form for the Mt. Pleasant Chapter of the National
  Honor Society. Please complete all sections by our first meeting of the second semester which will be dated.
  You are welcome to submit it in to Mrs. Cocovich in room 1202 beforehand.

 I.   Member Information (Please type or print):

      Name: _______________________________                    E-Mail: _________________________________

      Student ID#: __________________________                  Phone Number: ___________________________


II.   Community Service Project

      Name of project: _____________________________________________________________________

      (Brief Description):

      _____________________________________________________________________________________

      _____________________________________________________________________________________

      _____________________________________________________________________________________

      _____________________________________________________________________________________

      _____________________________________________________________________________________

      When did you begin? (mm/yyyy)                                 Hours per week:

      _____________________________________                         _____________________________________

      Total Hours (to date):                                        Supervisor’s Signature:

      _____________________________________                         _____________________________________



  I affirm that all information in this form is true, complete, and answered to the best of my ability. Any
  misinterpretation, false statement, or omission of facts shall be grounds for punishment.

  Applicant’s signature and date:

  Name:______________________________________________                  Date: _____________________________

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Community Service Project Form

  • 1. MT. PLEASANT CHAPTER OF NATIONAL HONOR SOCIETY Community Service Project Report Form Directions: This is the community service project report form for the Mt. Pleasant Chapter of the National Honor Society. Please complete all sections by our first meeting of the second semester which will be dated. You are welcome to submit it in to Mrs. Cocovich in room 1202 beforehand. I. Member Information (Please type or print): Name: _______________________________ E-Mail: _________________________________ Student ID#: __________________________ Phone Number: ___________________________ II. Community Service Project Name of project: _____________________________________________________________________ (Brief Description): _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ When did you begin? (mm/yyyy) Hours per week: _____________________________________ _____________________________________ Total Hours (to date): Supervisor’s Signature: _____________________________________ _____________________________________ I affirm that all information in this form is true, complete, and answered to the best of my ability. Any misinterpretation, false statement, or omission of facts shall be grounds for punishment. Applicant’s signature and date: Name:______________________________________________ Date: _____________________________