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Douglas Anderson Verification of Community Service 2013-2014 (Bright Futures Program ) (Revised 7/2/2012)

C/O 2014: To qualify for Bright Futures Scholarship, you must submit your hours by Graduation, 2014. Student Number Student Name (Please Print) ______________ Grade______ Date_________

To avoid disappointment please be sure to get your project pre-approved.

Total # of Hours listed below ___________


PreApproval Date of Service m/d/year (Beg-End) # of Hours Club/Organization/ Non-Profit affiliation Type of Volunteer Work (activity or task performed) Site of Volunteer Work (Please Print) Name of Verifier Verifiers Signature Verifiers Phone Number

PLEASE REMEMBER THAT ALL BLANKS ARE TO BE FILLED IN AND VERIFIED AND THAT NUMBER OF HOURS ARE TO BE TOTALED. See back for more important information!

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