Community Service Input Form



Instructions:  Please review the Community Service Guideline to insure you are in compliance with current directives, policies, and guideline for submitting your Community Service.


Community Service Questions? Email Gene Davenport at


First Name

Last Name

This Activity Supported

(Select From Pull Down Menu)


Date of Activity

Note: If activity covered more than  one date - then list the last date and in the Description of the Activity show the From and To Dates

Round Trip Mileage

Note: This mileage is  your round trip mileage to and from the activity. If your activity was over several days - total your mileage. Use only whole numbers


Note: Hours you spent supporting this activity, if your activity was over several days - total your hours. Use only whole numbers

Money Expended

Note: Indicate the total amount of funds expended to support this activity.  No "$" Sign - Round Up To Whole Dollar. 

Do not calculate hours into a dollar amount. 

Description of Activity

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