community service approval form - Pope John Paul II Catholic High ...

COMMUNITY SERVICE APPROVAL FORMPOPE JOHN PAUL ll CATHOLIC HIGH SCHOOL MISSION STATEMENTThe mission of Pope John Paul II Catholic High School is to serve the families of our Catholic parishes and thewider community in general by providing a Catholic education in a caring environment that stresses academicexcellence.Pope John Paul II Catholic High School is committed to developing the total person in body, mind and spirit.We pledge to teach the message of the Gospel and the tradition, to form a school community of faith, to provideexperiences of liturgy and prayer, and to guide the students to loving service.We will encourage, challenge, and support each student to learn enthusiastically, to lead honorably, and to liveresponsibly in our world.Upon choosing a service activity, it is the responsibility of the student to seek the approval of a JPll Staffmember before beginning the project. Projects that have not been approved in writing before work begins(especially if they do not have non-profit status) may not be considered part of the 100 hours of required service.Students transferring from other schools are required to have 25 hours per year at Pope John Paul II Catholic HighSchool. Approval – to be completed by student and JPII StaffPlease complete entire form *Indicates required fieldsDate*Student’s Name:*Class of: 14 15 16 17 *Organization Name:*Organization’s Contact Person:Contact Person’s Phone Number:*Description of Proposed ServiceApproved byDateJPII Staff Member*(If not a non-profit agency or organization e.g. a school, church, civic organization, etc…)To be completed by Service Supervisor:*Name & Title of Supervisor*Service Date(s)*Hours CompletedPlease rate the JPII CHS Student on the following criteria by circling the appropriate comments listed below andprovide additional comments on the back of this sheet:*COOPERATION Excellent Very Good Good Fair Poor*EFFORT Excellent Very Good Good Fair Poor*ATTITUDE Excellent Very Good Good Fair Poor*INITIATIVE Excellent Very Good Good Fair PoorI verify that the Pope John Paul II Catholic High School student named above provided service to the peopleof our organization for the number of hours on the date(s) listed above.*(Service Supervisor Signature)

COMPLETE BACK SIDE OF FORM FOR MULTIPLE HOURS ON THE SAME PROJECTRev. 05/24/10HOURS COMPLETED FOR THIS PROJECTDATE TIME-IN TIME-OUT DAILY TOTAL________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________FINAL TOTAL ______Rev.06/13/11