“Outside” hours for

NHS

You are able to do up to 5 hours of service outside of NHS projects towards the 20 hours of service needed each year. 5(and up to 10) must be tutoring, and 5(and up to 15) must be NHS driven activities.

AFTER you have filled out the entire form:

• This form needs a pre-approval signature from Colleen.
•  Please have an adult sign off on this form, preferably not your parent, who has witnessed the activity or is in charge of the volunteering,

Thank you!

NHS Member Name: ____________________________________

Activity: ______________________________________________

Pre-approval: __________________________________________

Please describe the activity and what you did.

Date(s) of activity: ___________________________________

Total hours: ________________________________________

I agree that the above student completed the aforementioned volunteer hours on the written dates.

Signature of adult supervisor: ___________________________________

Phone number: ________________________________