Intent to Serve Form

 


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"Intent to Serve" forms should be submitted for any service that is not listed as "pre-approved" on the OLGCHS Service webpage.  If opportunities have not been approved before they are performed, hours may not be accepted for credit. Once an "Intent to Serve" form has been submitted, someone will respond to your request for approval within one week.

To complete the following, copy and paste the following text into a Word document and e-mail to service@olgchs.org.

OUR LADY OF GOOD COUNSEL HIGH SCHOOL

XAVERIAN COMMUNITY SERVICE

INTENT TO SERVE FORM

2007-2008

NAME: _______________________________________________________

DATE OF REQUEST FOR APPROVAL: __________________________

STUDENT ID: ____________         GRADE: ________             COMMUNITY: ____________________________

ORGANIZATION TO BE SERVED: _____________________________________________________________

ORGANIZATION CONTACT NAME: ___________________________________________________________

ORGANIZATION CONTACT PHONE NUMBER: ________________________________________________

WHEN DO YOU PLAN ON COMPLETING THIS SERVICE: _______________________________________

WHAT WILL YOUR RESPONSIBILITIES BE?

 _____________________________________________________________________________________________

_____________________________________________________________________________________________

WHY DOES THIS ORGANIZATION NEED YOUR SERVICE? 

_____________________________________________________________________________________________

_____________________________________________________________________________________________

JRS & SRS: HOW DOES THIS ORGANIZATION SERVE THE POOR & MARGINALIZED

_____________________________________________________________________________________________

_____________________________________________________________________________

 

PARENT’S SIGNATURE: ____________________________________________________________________

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(Please complete the following information if you are submitting a paper copy.  You do not need to fill this out if you submitting this via e-mail.)

Student Name:  _____________________________   Community: _______________________

Service Organization: ______________________________   Date Submitted: _____________

 

Text Box: For Administrative Use Only:                                            ?  Approved
                                                                                                ?  Denied
Date:                                                                                       ?  Requires further clarification, please see Mrs. Egan
Initials:                                                                                        in the Campus Ministry Office

 

                                               

 

                                Please return this form to the Campus Ministry Office or to service@olgchs.org


Last updated September 5,  2007

For information on the Campus Ministry Department go to http://TeacherWeb.com/MD/GoodCounsel/CampusMinistry