WESTFIELD CIVIC SERVICE PROJECT
STUDENT/PARENT AGREEMENT FORM
Student Name: Phone:
Agency:
Address:
Contact Person: Phone:
Duties to be performed:
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
PARENT AGREEMENT: I give permission for
to participate in the Civic Service Project. I understand that my son/daughter must arrange his/her own transportation.
As a student, I agree to complete the hours I have committed to. I will be: SENSITIVE, RELIABLE, DISCRETE, FLEXIBLE, MATURE, and I will take INITIATIVE. I will be responsible for the job that I do, and will keep a positive attitude.
We, the undersigned understand the responsibilities and commitment of this Civic Service Project.
__________________________________________________ ____________________________
Parent Signature Date
Student Signature Date
NOTE: Fill out this form and return to the classroom teacher by the assigned date.
Westfield High School
Civic Service Project
Attendance and Evaluation Sheet
**Note: You will need a separate sheet for each agency you volunteer for.
Student Name:
Agency Name: _________________________________________
Agency Address:
Contact
Person(s): Phone:
______________________
___________________________________ Email:
______________________
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Additional Comments/Feedback:
Reminders
**As this is a
volunteer experience, you are NOT allowed to count hours of
service for which you are paid.
_____________________________
Student Signature
**By signing above you agree to perform this service according to the
rules and guidelines
detailed on the project description handout, and specifically to
record only those hours
you actually worked (no double hours) and service for which you did
NOT receive pay.