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2017-18 POINTS SHEETS

2017-2018 BETA Club

Official Points Sheet

 

Student Name ____________________________________  (print)             Grade _______

 

Date of Activity/Service ___/___/_____

 

Name of Activity/Service _________________________________________________

 

Location of Activity/Service _______________________________________________

 

Brief Description of Activity/Service ___________________________________________

 

_______________________________________________________________________

 

_______________________________________________________________________

 

_______________________________________________________________________

 

_______________________________________________________________________

 

Start Time ___________am/pm                           End Time __________am/pm

                                               

                                            Total # of Hours ______

 

Student Signature ________________________________

By signing this form, I am attesting that the information is true.

I am also aware that I cannot receive double credit for service

Hours that I report for other clubs, societies, groups, etc.

                                            ……………………………………………………………………………

VERIFICATION INFORMATION

 

Supervisor’s Name ____________________________  (print)

 

Supervisor’s Title ___________________________    Phone # ____________________

 

Organization/Group Being Represented _________________________________________

 

Supervisor’s Signature ___________________________

 

Comments:

 

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