Cathedral Preparatory School
and
Villa Maria Academy
Service Hour Verification Form
Student Name: __________________________________________________
Grade: __________
Hours: __________
Non-profit Agency: ______________________________________________
Date of Service: _____________________
Event Name (if applicable): ________________________________________
Supervisor’s Name (please print): ___________________________________
Phone Number: ______________________
Supervisor’s Email: ____________________________________________________________________________________
Supervisor’s Comments: _________________________________________________________________________________
_____________________________________________________________________________________________________
Student Responsibilities: ________________________________________________________________________________
_____________________________________________________________________________________________________
(Supervisor’s Signature)
**not a parent or guardian of this student
(Student’s Signature)
(Theology Teacher’s Signature)
(Date)
To be completed by student: Please check the description below that best describes this type of service.
[] Church/School [] Young People
[] Adults living and working in poverty [] Sick and Elderly
[] Community Service
Please explain the reason for your selection:
General Requirements- All Students Will:
1.
Complete a minimum of 25 service hours each year, in the form of direct service to the communities of church, school, or society.
Students who enroll after the beginning of the year will complete hours in proportion to their date of enrollment.
2.
Complete five (5) of the required 25 hours in specific service areas assigned by class:
a. Freshmen: service to the school and parish community
b. Sophomores: service related to justice for the young
c. Juniors: service related to justice for adults living and working in poverty
d. Seniors: service related to justice for the sick and elderly
3.
Document all service hours by using the appropriate verification forms and submitting completed forms to their theology teachers.
4.
Submit a summative reflection essay as directed by their Theology teachers in May.
Community service refers to the work people do whereby they learn the needs of the community and sacrifice their time
to meet those needs through personal contact or advocacy without pay or other compensation.
This is done for non-profit, charitable entities to benefit groups of people in need.
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