Community Outreach Time Log Form
Please complete this form to log your time and activities for community outreach efforts.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Outreach Activity
*
-
Month
-
Day
Year
Date
Start Time
*
Hour Minutes
AM
PM
AM/PM Option
End Time
*
Hour Minutes
AM
PM
AM/PM Option
Type of Outreach Activity
*
Please Select
Food Distribution
Community Clean-Up
Educational Workshop
Health Awareness
Fundraising
Other
Location of Activity
*
Organization/Group Represented (if any)
Description of Work Performed
*
Total Time Spent (in hours)
*
Additional Comments or Feedback
Supervisor Name (if applicable)
Supervisor Approval (optional)
Approved by Supervisor
Submit Log
Should be Empty: