My Service at a Glance

 

Organization where

 

 

Your

How

 

 

 

 

Issue or need

Organization that helped

Description

role in

Project

Hours

End

Total

you performed your

many

you find your service

service

start

per

date or

hours

(see below)

service (supervisor,

of project

people

(contact, phone #)

(see

date*

month

ongoing

to date

 

address, phone #)

 

served

 

 

 

below)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

J. Anderson Cultural Center,

 

Provided individual

 

 

 

 

 

 

 

St. Joseph’s Service Center

attention to

 

 

 

 

 

 

Example:

Barbara Jones, 54th and

 

20

 

 

 

 

Jacob Smith

children; tutored

1, 3

9/02

16

ongoing

96

Literacy

Overbrook Ave, Philadelphia,

youths

610-555-5555

reading and

 

 

 

 

 

 

PA 19130 , 215-555-5555

 

 

 

 

 

 

 

 

writing skills

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Issues or Needs

Children

Elderly Environmental Health Homeless Hunger Literacy Poverty

Public Safety

Social Justice

Special Needs

Youth at Risk Other

Role in Service

Choose all that apply from the following list

and enter the corresponding numbers in the chart above.

1. Participated in an established service project

2. Started this service project

3. Coordinated and/or organized parts of the project

4. Mentored other volunteers

*Start dates begin from the previous summer to the present.

Answer the questions that apply to you.

Have you:

Advocated for this service project by speaking or writing? Speaking Writing

Where? ________________________________________________________

Who was your audience? __________________________________________

Recruited others to service? ________________________________________

How many? ____________________________________________

Fundraised for this project? ________________________________________

How? __________________________________________________

How much did you raise? __________________________________

Comments: ____________________________________________________