Community Service Verification Form

Biology 101  Environmental Biology

See syllabus for due date.

To the organization: This student is participating in your volunteer project to fulfill requirements for an environmental biology course at Clark College.  The requirement for service is 7 hours which must be verified by the organization through a form we provide.  Thank you for working with our students.  Please contact me if you need additional information (Steven Clark 992-2203). 

Student Name _______________________________________________________________

Name of Organization _______________________________________________________

Description of volunteer activity (to be completed by student):

Start date for project______________________________________________________

Expected completion date_________________________________________________

Activity Supervisor or Volunteer Coordinator:

Name:                                                           Signature:_____________________

Phone:

Email:

To receive credit for your arrangement of community service, I will need a phone call, verifiable email or signature (above) from your supervisor.  My initials here ______ means I have received acceptable confirmation from your supervisor.