Volunteer Flyer Distribution Report
(Please complete the form to record verifiable distribution of DSL flyers) Community Service Credit Hours Awarded: 1-5 Hours/per Distribution Location
Flyer(s) Given to:
1. Non-Profit/Organization Representative
2. Local Bulletin Board (@ Church, Shelter, AA, etc.)
3. Individual
1. Organization & Rep Name
Organization
Representative Name
2. Bulletin Board Location
Name of Church, Shelter, AA, etc.
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of
3. Volunteer Name
First, Last Name
Email Address
Required for Individual Only
Submitted by:
Required for Accurate Community Service Credits
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