DEMONSTRATION 16
ROCKLIN HIGH SCHOOL COMMUNITY SERVICE CONTRACT
Objective: To provide an opportunity for students to make meaningful connections and enrich the lives of others by performing service for their community without receiving any external rewards or compensation of any kind. Unless pre-approved, activities will take place outside of the student’s school day.

Steps To Follow:
  1. Read over these guidelines.
  2. Research pre-approved community service opportunities in the Career Center.
  3. Contact the appropriate organization, group, or person, and arrange for a time to complete this service project.
  4. Conscientiously fulfill responsibilities as agreed.
  5. Complete the COMMUNITY SERVICE CONTRACT below. Hours must be documented on the backside of the contract and signed off by the supervisor. The student, parent and supervisor must sign the front of the contract.
  6. When the community service project is completed and contract completely filled out, MAKE A COPY of the contract before turning it in to the Career Center.

Please Print or Type
STUDENT NAME: _________________________________________________________________________

STUDENT NUMBER: _______________________ CLASS OF ______________________________

ORGANIZATION/GROUP/PERSON: ____________________________ TELEPHONE: _____________

SUPVERSIOR: _______________________________________________ TELEPHONE: _____________

RESPONSIBILITIES: ________________________________________________________________________

___________________________________________________________________________________________

X ________________________________________ X _______________________________________
Student’s Signature/Date Parent/Guardian’s Signature/Date

X ________________________________________ HOURS SERVED: _________________________
Supervisor’s Signature/Date (From back of Contract)

(Upon Completion of C.S. Project)

PRE-APPROVAL required through Career Center if there is a question about the validity of the community service project. Pre-approval signature must be obtained prior to performing community service hours.

X _______________________________________
Pre-Approval Signature

PLEASE STATE YOUR OBSERVATIONS OF WHAT YOU LEARNED PERFORMING THESE COMMUNITY SERVICE HOURS:

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

For Career Center Use Only

HOURS DOCUMENTED __________ DATE ENTERED __________ INITIALS ___________ TOTAL HOURS TO DATE ___________

I\Community Service Contract Revised 8/99