Instructions:
  • Fill in the form.
  • Print the form.
  • Have your supervisor sign the form.
  • Submit the hard copy version of the form to the CAS Coordinator.
Name:
Email:
Homeroom:
Homeroom Teacher:
Description of Completed Activity and Your Role (Creative/Active/Service):
Hours Completed :
Date of Activity :
Name of Activity Supervisor:
Contact Number of Activity Supervisor:
Signature verifying completion of activity and number of hours completed