Community Service Report
Community Service Policy: A minimum of 20 hours of community service per year of enrollment with Griggs is required.

Name (Last, First, MI): *
Student ID#: *
Dates Served (mm/dd/yy to mm/dd/yy): *
Total Hours of Service: *
Description of project, including duties performed: *
With my signature I verify that I have completed the community service as recorded above: *
Date Signed:
Signature of Supervisor: *
Organization: *
Phone: *
Address: *
City: *
State: *
Zip: *
Fields marked with an * are required.

Formerly Home Study International

Griggs University

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