PROPOSAL FORM

Student Name: ________________________________________________________________

Name of Agency or Project: ______________________________________________________

Description of Duties: ___________________________________________________________

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Project starting date: __________________ Ending Date: __________________

Approximate number of hours spending on project: ____________________________________

Project Sponsor’s Name: _________________________________________________________

Address: ______________________________________________________________________

Telephone: _______________________

I agree to abide by the guidelines, procedural and evaluative, that are proposed by the Community Service Committee. I also understand that if my project has been approved, it is my responsibility to submit a completion form when the proposed project is completed. This community service project includes those activities that have been completed between the end of June and/or Senior Civics trimester.

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Student’s Signature