Presidential Volunteer Service Award Application Form

Presidential Volunteer Service Award Application FormFor Leesville Road High School 2008-09(Mail form to: Monica Macia, 11809 Old Creedmoor Road, Raleigh, NC, 27613Or take it to the High School, marked PTSA/Monica Macia)Name of Applicant: ___________________________________________________________Home Address: ______________________________________________________________________________________________Home Phone Number: _________________________________ Parent’s Email: _______________________________________(Please Print Clearly)Total number of hours submitted: ___________________Community Service Record (Note – this can be an attachment, especially if the applicant has already recorded and verified these hoursfor another organization such as the LHS Key Club, or LHS National Honor Society. If not, please use the form below)Date Volunteer Work # of Hours Adult/Event Organizer Signature* Phone number(Give short description of work) (*signature not needed if we can call to verify activity)_______ ________________________________ _________ ___________________________ ______________________ ________________________________ _________ ___________________________ ______________________ ________________________________ _________ ___________________________ _______________

Presidential Volunteer Service Award Application FormFor Leesville Road High School 2008-09Page 2 (copy this page as needed for more pages)Date Volunteer Work # of Hours Adult/Event Organizer Signature Phone number_______ ________________________________ _________ ___________________________ ______________________ ________________________________ _________ ___________________________ ______________________ ________________________________ _________ ___________________________ ______________________ ________________________________ _________ ___________________________ ______________________ ________________________________ _________ ___________________________ ______________________ ________________________________ _________ ___________________________ ______________________ ________________________________ _________ ___________________________ ______________________ ________________________________ _________ ___________________________ _______________