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Required
Student Name
Grade
Project Information
Agency Name
Address
Address 2
City
State
Zip
Project Description
Dates of Service
Number of Hours
Supervisor's Contact Information
Name
Phone
Email
Student Reflection
Explain why you chose to serve at this particular agency, and describe how you felt before, during, and after your service.
Are you planning on continuing this service project? If so, describe your plans. If not, explain why not.
What did you observe?
What issue or population was being served?
Student Reflection
What did you learn about the issue or yourself?
How was your experience different from what you expected?
How can you apply what you learned during this experience to your daily life?
What information can you share with your friends or neighbors to improve the issue?
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