Documentation of Volunteer Activity

Please Print Legibly!!!

It is ultimately up to the KDE President to grant or deny your request to count these hours towards the five required volunteer hours.  Don’t forget that the volunteer hours must be education-related.  Please be sure to clearly explain your involvement and activity.

 

Student Volunteer

 

 

Email Address

Student Phone

Date Submitted

 

 

 

Location of Volunteer Event

 

 

Phone Number for Location

Supervisor’s Name

 

 

Supervisor’s Phone Number

 

Date of Volunteer Activity:

 

Time of Volunteer Activity:

Total Volunteer Hours:

 

Please describe your volunteer experience:

 

 

 

 

 

 

 

 

 

 

 

 

 

Signatures

 

 

Supervisor                                        Date

Volunteer                                          Date

 

In order to receive credit for your volunteer hours, this form needs to be fully completed and returned to your group leader by the designated date.