Last Name
First Name
Today’s Date
“On-going Community Service” Log
Please complete this log as you complete your service to your organization. Remember to have
your supervisor sign this document. Turn this form in to the Vice President or the Points
Secretary by the due dates. Before turning it in, you may want to make a copy for your records.
Name of organization and city:
General role of your service to this organization:
Supervisor’s name and title:
Supervisor’s contact information:
Date
Description of Service
Record
Start
Time
Example:
2/3/2014
Prepared approx 45 meals. Served meals. Cleaned kitchen.
End
Time
Total
Time
TOTAL HOURS
“I verify that this volunteer has completed the services and hours as listed above.”
Today’s Date:
Supervisor’s Signature:
For Office Use Only
Date Entered
VP/PS Signature
 Alpha Gamma Sigma Honor Society  Sigma Rho Chapter at Chabot College 
Supervisor
Initials