Sport Clubs Community Service Form 11 12 by 0n9axIhb

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									 Club Name                                             Sponsoring Org.
 Contact Person                                        Contact Name
 Phone                                                 Contact Signature
 Email                                                 Contact Phone
 Date                                                  Contact Email

       Must be completed no later than 5 business days after conclusion of
                community service to receive Report Card Points.
NAME OF COMMUNITY SERVICE:_______________________________________________________________
IS THIS A RE-OCCURRING PROJECT?                     YES      NO       (If YES, you only need to fill out one form for all dates)
SERVICE DATE(S):____________________________________________________________________________
SERVICE TIME(S):____________________________________________________________________________
SERVICE DESCRIPTION:_______________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
OTHER INFORMATION:_______________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________

NUMBER OF MEMBERS INVOLVED:_____________________________________________________________
TOTAL HOURS WORKED:______________________________________________________________________
                **Please list all participants and their hours worked on the next page**
  **Make sure each individual records their hours with the Center for Leadership and Civic Engagement**
                           http://leadandserve.usf.edu/forms/hoursindiv.htm

DO YOU PLAN ON DOING THIS COMMUNITY SERVICE AGAIN?                                              YES               NO
WOULD YOU RECOMMEND THIS COMMUNITY SERVICE TO OTHER CLUBS?                                      YES               NO
WHY OR WHY NOT?:_________________________________________________________________________
__________________________________________________________________________________________

-------------------------------------------------- SPORT CLUB OFFICE USE ONLY-------------------------------------------------------

             Received By:
             Date Received:
             Date Entered into Report Card:
             Total Points Received:
CLUB NAME:_______________________________________________________________________________
NAME OF COMMUNITY SERVICE:_______________________________________________________________

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