Religion Dept Form

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MOORE CATHOLIC H.S.

100 MERRILL AVENUE

STATEN ISLAND, NY 10314

718-761-9200

Community Service Hours

Student Name ___________________________________________

Organization _____________________________________________

Contact Person __________________________________________

Contact Phone Number __________________________________

Organization Address ____________________________________

__________________________________________________________

DATE

IN

OUT

INITIALS

TOTAL TIME
         
         
         
         
         
         
         
         
         
         
         
         
         
         
         
         
         
         
         
         

PLEASE RETURN TO MRS. WONDOLOWSKI IN THE DEAN’S OFFICE

 

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