Service Agreement

RECORD OF SERVICE HOURS

2016-2017

NAME OF PARENT(S)  ­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­___________________________________________________________________

NAME(S) OF STUDENT(S)  ________________________________________________________________

SERVICE RENDERED (Work Day, Concessions, Santa Store, etc.)

NUMBER OF HOURS

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TOTAL NUMBER OF HOURS COMPLETED                                                                                 ________________

• I have completed my service hours for the 2016-2017 school year as indicated above.

• I have opted to pay the $200.00 assessment in lieu of submitting service hours and have already paid for the year.

• I have opted to pay the $200.00 assessment in lieu of submitting service hours. Please find my payment of $200.00 attached.

• I have completed a portion of my service hours to the school (listed above) and have attached a partial payment in the amount of $10.00 per hour to cover the remaining hours.