Individual Service Project Form-Seniors

Name .

Homeroom

A total of 20 hours are mandatory for continued membership. For seniors, these hours must include a minimum of 10 hours of participation in Chapter Service Projects. 10 hours must be completed between June 26th and the last day of the fall semester of the senior year. The final 10 hours must be completed by May 15, 2015.

This quality is defined through the voluntary contributions made by a student to the school or community, done without compensation (such as financial compensation, academic credit, public notoriety, reward or development toward future academics or occupation), and with a positive, courteous, and enthusiastic spirit. This service must occur within the Fairfield community.

Please note that it is not the membership in a club or group, but applicable contributions made therein that counts as community service. To help you discern which of your activities falls under the above definition, we have provided the following examples:

Name .

Homeroom

Does Not Apply

· practice & competition in baseball

· practice & performance in a theatrical production

· membership in student council

· Key Club membership

· fundraisers for non-service teams, clubs or activities (ie. Baseball pizza sale)

Does Apply

· participation with the baseball team in a free clinic for Little League players

· participation in a free performance done at a nursing home

· planning & participation in the student council clothes drive

· planning & participation in the Key Club “Can Tab Drive”

· fundraiser for nonprofit

Name .

Homeroom

Any questions regarding the acceptability of an activity for which you would like counted as service must be discussed with the advisor before the hours due date. The interpretation of the above definition and the resulting acceptability or unacceptability of an activity listed in your application as service is ultimately up to the NHS faculty council.

Directions: Using the examples below as a guide, record service activities you would like considered in the table provided.

Activity & Group Name / Brief Description / Duration
(Fill in & circle the appropriate info) / Date(s) / Supervisor’s Name
Signature & Printed / Phone
Number
Toys for Tots
Student Council / Collected toys for needy children / day day
5 hours per week for 1 week
month month
year year / 12/20/13 / Francis Falcon / 203-255-5555
ext. 5555
Neonatal care
Yale-NH Hospital / Held, fed, etc. premature babies in the neonatal care unit / 1 hours per week for 8 week
month month
year year / 9/13 – 1/14 / Patsy Perch / 203-255-1234

Individual Service Project for NHS

10 hours due no later than the start of Midterm exams 2015 by 2:30 in room 349. Another 10 hours are due by 5/15/15.

Please highlight any of the hours on this form that would qualify as tutoring.

Activity & Group Name / Brief Description
(attach separate sheet if more space is necessary) / Duration
(Fill in & circle the appropriate info) / Date(s) / Supervisor’s Name
Signature & Printed
Location of Activity / Phone
Number
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