Community Service Verification Form

A Community Service Verification Form is used to verify community related activities of a candidate undertaken on voluntary basis. These activities are done towards social obligation and for the benefit of the society.

Sample Community Service Verification Form

First Name______________________Middle____________________Last Name

Date of Birth________________________________ (DD/MM/YY)

Permanent Address Street_____________________________

State_________________________County____________________ZIP

Country______________________

Day Phone__________________________Mobile_________________________

Email_______________________________Fax Number_____________________

Community Work Details:

Name of the Organization affiliated to_____________________________________

________________________________________________________________________

Description of each activity in 100 words Max.

Old Home:__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Environment:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Juvenile Crimes:_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Education:______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Purpose/mission behind the activity

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

How did the Community benefit?

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Write about your Experience and Impressions_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Would you be interested in any other below mentioned services in future? Tick against the ones you prefer. You will be contacted soon.

1. Assisting  Community through church related Services      – Yes/No
2. Helping at the Hospital         Yes/No
3. Tutoring after school   Yes/No

Kindly sign and submit at the community office

________________________________________________________

Signature                                           Date

Category: Verification Forms