BOARD OF GOVERNORS SCHOLARS
SERVICE PROJECT PROPOSAL
Before starting your community service project, you must have this form completed and
turned in for approval by the Assistant Director of the BOG Program. Refer to the BOG
Community Service Requirement sheet for due dates.
PRINT NAME:
ID NUMBER:
DATE:
EMAIL:
PLEASE CIRCLE:
Freshman
Sophomore
PLEASE CIRCLE:
Fall
Spring
Junior
Senior
SERVICE PROJECT LOCATION:
ADDRESS:
PHONE:
Give a brief description of what you’ll be doing for your community service project.
Community Service Supervisor
Signature
Print Name
Date
Office use only
Approved
Disapproved
Assistant Director, BOG Program
Copy Sent to student
Date
BOARD OF GOVERNORS SCHOLARS
COMMUNITY SERVICE VERIFICATION SHEET
Student’s Name:
ID Number
Please Circle:
Freshman
Sophomore
Please Circle:
Supervisor’s Name (print):
Service Project Location:
Service Project Phone Number:
Fall
Spring
Junior
Senior
This form is to be used to record the dates and times of your community service. Please be sure to
get your supervisor’s signature as you complete your hours.
Date
Total
Hours
Supervisor’s Signature
________________
* Note: Your community service experience must be a total of at least 15 hours for a full scholarship and 7.5 hours
for a half scholarship. All completed hours must be with one organization.
Date received: ____________