COMMUNITY SERVICE RECORDING FORM

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CONGREGATION B’NAI SHALOM
CHAI SCHOOL

CHAI SCHOOL C COMMUNITY SERVICE RECORDING FORM

ONE JEC IS EARNED FOR EACH HOUR OF SERVICE

SUBMIT 1 FORM FOR EACH AGENCY/ACTIVITY/UP TO 10 HOURS

Student First and Last Name

Grade in School 2025-2026

Cell Phone

Name and address of agency where student volunteered

Briefly describe the nature of the volunteer’s work which was completed.

Explain in three or more sentences why you believe this activity is an appropriate part of your Jewish Education.

Would you do this type of volunteer work again?

YesNo

Would you recommend this volunteer work to one of your friends?

YesNo

Number of Hours Voluneered

12345678910

Thu, July 31 2025 6 Av 5785