Panola Promise: Volunteer Service Verification Form

Panola Promise: Volunteer Service Verification Form

All hours must be submitted by May 15th each school year.
As part of the Panola Promise, students are required to complete 25 hours of volunteer/community service each year during their sophomore, junior, and senior years once pledged to the Promise Program during high school to maintain eligibility.

Some examples of Volunteer/Community Service:
- Helping at a nursing home
- Volunteering at a food pantry
- Assisting a civic organization
- Tutoring
- Community clean-up
- Volunteer with a church group
- Assisting with community projects
How many hours of service am I supposed to complete?
- Twenty-five (25) service hours or more in your sophomore year of high school.
- Twenty-five (25) service hours or more in your junior year of high school.
- Twenty-five (25) service hours or more in your senior year of high school.
Submitting Volunteer Service Hours
- Submit all 25 hours by May 15 each year.
- Submit all service hours for Panola Promise on this electronic form.
- You may submit a form after each service hour/ job is completed throughout the year or all at once on one form. It is your choice.
- Once your submitted hours have been logged by the staff, you will be sent an update with how many hours you have total and how many you have left to meet the 25 hour requirement.

Panola Promise: Volunteer Service Verification Form
All hours are due by May 15. If you do not have 25 total hours submitted by May 15th each school year, you will no longer be eligible to participate in the program.

Hours must be volunteered, and students may not receive any payment or reward for participating. Providing false information will result in the student's disqualification from the Promise Program.
Name*

First NameMiddle NameLast Name
Student Email*

Confirmation Emailexample@example.com
Student ID # (High School)*
Parent/Guardian Email*
example@example.com
Expected Year of High School Graduation*
Name of High School*
Volunteer Service: (You may submit multiple jobs on one form.) All fields are required**
Please add a photo of you completing your volunteer service work. This is not a requirement, but we love to get pictures of you out an about for the Panola College Promise Program. By uploading a photo and signing the form you agree that we can use your photo for media and promotional purposes for Panola College.
By signing below, I affirm that the information provided on this form is true and accurate to the best of my knowledge. I also affirm that I did not receive any payment or reward for the act of service and that the service hours completed are in accordance with the definition of community service outlined for the Panola Promise.

I understand that my community services hours will be confirmed, and if any information provided on this form is found to be false, I will become ineligible for the Panola Promise.
Student Signature

Clear
Should be Empty: