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Stuff

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Father Gabriel Richard Catholic High School
Christian Service Hours Report Form 2014-2015 "Truly I say to you, as you did it to one of the least of these my brethren, you did it to me." Matthew 25:40

Summer service due by September 5th. Service completed during the school year due no later than 1 week of completion of service. Late forms will not be accepted.
Your Name: ____________________________________________________________ Your Grade: _________ Parent’s Signature: _____________________________________Date of service:____________________
Do not place forms in mail boxes or turn into the office. Forms are handed directly to these designated teachers: Sr. Sarah ~ SENIORS Mrs. Norton ~ JUNIORS Ms. Buckler ~ SOPHOMORES Mrs. Scherr ~ FRESHMEN

The final deadline to turn in your forms is April 30, 2015
Please refer to the Student- Parent Handbook for complete details regarding Christian Service. Any questions about your service should be directed to the teacher listed above for your grade level. Please look for a monthly progress report on Edline which will show your hours approved. You must maintain a copy of all forms turned in for your records.

Part I: Where did you perform this service?
Name, Address, Phone Number of agency: ______________________________________________________ ______________________________________________________

Names of other FGRHS students who also served with you ____________________________________________ REFLECTION: On the back of this paper write a paragraph about what you did, another paragraph about how Christ was reflected in your work and a third paragraph about how Christ was reflected in those you served. Approval of hours is contingent upon a well written reflection.

Part II: To be completed by adult supervisor (not a parent):
What assigned tasks did the student complete? MERCY o Served meal to homeless o Distributed items to needy o Visited the elderly in nursing home o Visited the sick in hospital o Worked with special needs persons o Participated in Mission trip o Worked at Special Olympics event o Counseled persons considering abortions o Served at funeral o Other (please specify) __________________________________________________ __________________________________________________

GENERAL o Worked (general, clerical) at a (sorted food, sorted clothes, filed) at

charity

o Served at parish (Altar server, EME, usher, etc) o Volunteered at parish event ________________________ o Volunteered at Vacation Bible school, Summer Camp o Volunteered at another school ______________________ o Participated in Blood Drive, donated blood at Red Cross o Volunteered at FGR Open House, Auction, Athletic Event o Other (please specify) __________________________________________________ __________________________________________________

Date(s) of service: _____________________________________ Number of hours: _____________________________ Signature ___________________________________________ Signature not available ______ Phone contact________________________________________ Best time to call to verify service _______ Would you be willing to have other FGRHS students complete their service with you? ________________________ ***************************************************************************************************************************************
For Christian Service Committee Use Only: Date Received_________Initials ______Hours Verified/Date___________Mercy Hrs Approved____ General Hrs Approved_____ Date Recorded_________I

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