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Christian Service Hours Form

* indicates required field

Student’s first name
Student’s last name
Student ID#
Date information: if service was performed of a period of time, please list the dates of service performed
Number of hours served: (if the total hours are over 3 months, please see Mrs. Frigge in the Campus Ministry Office.)
Name of the organization/individual for whom service was performed
Description of service performed
* Type of Christian Service hours Type of Christian Service hours
Red: economically poor / physically handicapped / disadvantaged member of society / verifiable need of a marginalized family / elderly
White: any church / school nonprofit business
Supervisor’s full name
Supervisor’s phone number
Supervisor’s email
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