SERVICE LEARNING RECORD SHEET Your name: ____________________________ Email address:__________________________ Your Grade (check one):

9th

10th

11th

12th

Service Learning Requirements: 9th Grade: 15 hours 10th Grade: 20 hours 11th Grade: 30 hours 12th Grade: 25 hours

Name of organization where you worked:______________________________________ How did you hear about this service opportunity?_______________________________ Date of service_____________ (mm/dd/year)

Number of hours worked:_________

Project leader or representative from the organization: Print name:_____________________________ Email address:_______________________ Signature:_____________________________________ Date:____________ Phone:_______________________________________ Position:_____________________ Organization's website:_______________________

Your complete answers can be typed or handwritten, but must be legible. 1. What type of service did you do, who did you serve and what did you accomplish? _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ 2. How is this service relevant to what you are learning in your classes? _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ 3. What are the most difficult and satisfying parts of the service that you performed? _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________