Fillable APPENDIX D COMMUNITY SERVICE FORM NAME DEPARTMENT (Pensacola State College)

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APPENDIX D COMMUNITY SERVICE FORM NAME DEPARTMENT (Pensacola State College)

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2018 – 2021 CBA
D-1
APPENDIX D
COMMUNITY SERVICE FORM
NAME
DEPARTMENT
Name of Agency, Organization, or Group:
Description of Activity:
Schedule of Days and Times Worked Each Week:
I certify that the community service described above is voluntary and that I will not receive any stipend
for the activity.
Faculty Member Date
Approved
Immediate Supervisor Date
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APPENDIX D COMMUNITY SERVICE FORM NAME DEPARTMENT (Pensacola State College)

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Completed 23 July 2020

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