Service Form

Examples of Service

School

  • Blood Drive (Donor or helper)
  • Stage crew
  • Tech crew
  • Recycling (SAFE)
  • Assisting faculty, staff, administration
  • Campus cleanup/beautification
  • Library volunteer
  • Peer tutoring Kids Voting
  • ROTC Color Guard
  • WPTD-TV volunteer
  • Selling concessions at athletic events
  • Helping maintain playing fields

Community

  • Meals on wheels
  • Habitat for Humanity
  • Nursing home volunteer
  • Hospital volunteers
  • Boys and Girls Clubs
  • Crop Walk
  • Soup kitchens
  • Food drives
  • Bike-a-thon
  • Nonprofit daycare volunteer
  • Scouting projects
  • Church mission trips
  • Other church service
  • (Choir, acolyte, usher)
  • Elementary and middle schools
  • (Tutor/mentor)
  • Public library
  • Museum volunteer
  • YMCA & YWCA volunteer
  • Ecological cleanups
  • PTO childcare for elementary schools
  • Parks and Recreation events
  • Kids Voting
  • Adopt-a-Highway
  • AIDS Service Agency
  • Red Cross
  • Cancer society
  • Salvation Army
  • American Lung Association
  • Nonprofit charitable clothing stores
  • First Night celebration
  • Arts festival
  • International festival
  • Mothers Against Drunk Driving
  • Political campaigns
  • Hospice fundraiser
  • Community theater
  • Tree planting in community
  • Homeless shelters
  • SOS (Save Our schools) After School
  • Programs (Tutor/Mentor)
  • Food bank
  • Special Olympics

First Name*
Last Name*
School*
Email*

List your most recent activities first. Examples of community service are listed above. Please include the date of service, the grade, a brief description of service, the number of hours and a contacts name and phone number to verify hours.


Service 1
Service 2
Service 3
Service 4
Service 5
Service 6
Service 7
Service 8
Service 9
Service 10
Total number of service hours*
State and clearly define your educational goals and aspirations:*
List leadership positions, club and activity participation. Arrange in chronological order beginning with your freshman high school year:*

IMPORTANT: This Community Service Activity Report form must be submitted with the Americana Scholarship Application.