Multi-Cultural Academy Charter School by 7A580Ru


									                    Multi-Cultural Academy Charter School
                            A Keystone Achievement Award-Winning Charter High School
                                    3821 N. Broad Street, Philadelphia, Pa 19140
                Telephone: (215)-227-0513 Fax: (215) 227-0415        E-mail:

                                 COMMUNITY SERVICE

Date: ______________

Dear Sir/Madam:

Our student, ___________________________, has expressed interest in
completing supervised community service with your institution/organization. All
of our students are required to perform community services at an approved non-
profit organization during each school year.

We are pleased that our student chose your institution/organization. If you accept
our student to do community services, please fill out the form below.

I, the undersigned, certify that our institution/organization is a non-profit entity and approve the
community service for the above student as follows:

Time and Days: from_________ to ____________, M, T, W, Th, F, S, Sunday

Period: from_____________________________ to ____________________________
                        Date                            Date

Brief description of the services to be performed by the student: _______________

Name: ____________________________ Position: _____________________________
Name of Institution/Organization: ____________________________________________
Address: __________________________________________, Telephone: ___________
Signature: __________________________________________, Date: _______________

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