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VERONA COMMUNITY SERVICE PROGRAM
“TEACHING RESPONSIBILITY THROUGH SERVICE”
WPA CONSTRUCTING THE RUNNING TRACK AT BROOKDALE PARK, 1935
VERONA HIGH SCHOOL
Community Service Deadlines
Early October Orientation presentation
Late November Parent Permission form is due
Mid December Request for Approval form is due
Early May 30 hours of community service should be
completed at this point as well as remaining
paper work and the Experience Report
Early June Student notified of approval or rejection
Helpful Hints/Procedures to Follow
1. Please remove the staple from this packet if you received one from me and do your best
to keep them neat. Make sure your name is on every form you hand in.
2. Your Experience Report (a.k.a. the essay) must be typed and be at least one page long.
3. Keep a log of the hours you spend in activities relating to community service. Be pre-
pared to submit that log. A blank form has been provided in this booklet.
4. Meet all of the above deadlines.
5. It is recommended that you keep a folder for all of your Community Service paperwork.
6. Do not lose the Community Service booklet you print or are given.
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VERONA HIGH SCHOOL
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COMMUNITY SERVICE PROGRAM
PROCEDURES TO FOLLOW
7. Complete the Community Service Program Request for Approval of Service form.
8. Have your parent or guardian complete the Parental Permission form.
9. Return both to Mr. Maher, Community Service Coordinator (CSC)
10. Meet with the CSC when possible.
11.Secure permission and begin service.
12. Maintain a log of hours of service.
13. Submit your log of hours of service, signed by your supervisor, to Mr. Maher. It is re-
commened that you also keep a copy for your own record.
14. Request For Approval of Service forms to be done prior to beginning every new serv-
ice. Although a meeting with the CSC is only required before beginning your first serv-
ice, a second or third meeting might be necessary prior to the beginning of any subse-
quent service.
15. Your written Experience Report, ( “the essay”) the Youth Volunteer Evaluation form,
Hours Log and the Evaluation of Placement form are to be submitted in May com-
menting on the experience. The contents of this report may be discussed in detail at
any one of your meetings with the CSC.
VERONA HIGH SCHOOL
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The Verona High School Community Service Program is voluntary and altruistic in
nature. High school students involved in U.S. History II volunteer their time to help those in
need. By doing so, the students are provided with an opportunity for great social commit-
ment, increased self-esteem, and heightened self-awareness. Any junior student can partici-
pate with parental permission and then choose from a number of service possibilities.
STUDENT RESPONSIBILITIES:
A. Complete the necessary forms.
B. Pay attention during the orientation session with the
Community Service Coordinator (Mr. Maher).
C. Comply with all procedures of the program.
D. Write an essay that comments on the experience (this is known as the Experience
Report).
EXPERIENCE REPORT (NOT INCLUDED AS A FORM IN THIS BOOKLET):
The culmination of the Community Service program is a written report. The purpose
of the report is to give you the opportunity to reflect about yourself and the difference that
you have made in the lives of others. It is expected that in this report you will comment on
the experience and what you have learned about people, yourself, life, and the world around
you. The report could include your volunteering intention in the future as well as your per-
sonal philosophy concerning the need to help others. It must be one typed page in length.
VERONA HIGH SCHOOL
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Your report may be presented in a variety of forms: keeping a journal or a
diary, completing observation reports and critical incident reports, preparing a
research project chosen and developed by you and approved by Mr. Maher in
order to reflect your expertise in your chosen activity, writing an essay describ-
ing what you have gained personally and academically from the experience.
Your report will be judged on the quality, depth and understanding which you
convey in your work.
VERONA HIGH SCHOOL
POSSIBLE PLACEMENTS:
LISTED BELOW ARE SOME SUGGESTIONS FOR YOUR PROJECT:
1. TEACHER’S AIDE
2. STUDENT TUTORS
3. PEER COUNSELORS
4. COACHING IN PARKS AND RECREATION PROGRAM
5. COLLEGE WOMEN’S CLUB OF MONTCLAIR
6. AFTER SCHOOL ARTS AND CRAFTS INSTRUCTORS
7. AMBULANCE CORPS
8. FIRE DEPARTMENT
9. PUBLIC LIBRARY
10. SCHOOL IMPROVEMENT PROJECTS
11. NURSING HOME WORK
12. CONSERVATION PROGRAMS (ENVIRONMENTAL CLUB)
13. CHURCH AND SYNAGOGUE SERVICE
14. SENIOR CITIZEN HOME VOLUNTEERS
15. HANDICAPPED SERVICES-SPECIAL OLYMPICS
16. C.O.A.P.
17. COMMUNITY CENTERS
18. SCOUTS
19. NON-PROFIT HUMAN SERVICES AGENCIES
20. SERVICE TO CLUBS OR CLASS
21.COMMUNITY THEATER
22. HANDS FOR HEARTS
23. LUMINARY NIGHT 6
VERONA HIGH SCHOOL
COMMUNITY SERVICE PROGRAM
Parental Permission
(only one of theses forms needs to be submitted)
STUDENT NAME:
ADDRESS:
PHONE:
DESCRIBE THE SERVICE TO BE PROVIDED:
YOUR SUPERVISOR:
My son/daughter has my permission to participate in the Community Service
Program at Verona High School as described in the accompanying booklet.
Date
Signature of Parent or Guardian
Comments:
VERONA HIGH SCHOOL
Name:
COMMUNITY SERVICE PROGRAM
AGENCY PARTICIPATION INFORMATION
NAME OF AGENCY OR ORGANIZATION:
ADDRESS:
PHONE:
PERSON AT SITE THAT WILL OVERSEE VOLUNTEERS:
Signature Date
Position with agency or organization
FOR VERONA PUBLIC SCHOOLS USE ONLY
Approved as a participating agency or organization in the Verona Public Schools Com-
munity Service Program.
Signature Date
PLEASE RETURN THIS FORM TO: VERONA HIGH SCHOOL
151 Fairview Ave
Verona, NJ 07044
ATTN: MR. ROBERT MAHER
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VERONA HIGH SCHOOL
COMMUNITY SERVICE PROGRAM
REQUEST FOR APPROVAL OF SERVICE
NAME: DATE:
GRADE:
PERIOD 1 TEACHER (Block 1 “A” Day):
TYPE OF SERVICE TO BE DONE:
AGENCY OR SCHOOL:
CONTACT PERSON:
TELEPHONE NUMBER:
SERVICE APPROVED
SERVICE NOT APPROVED
REASON FOR DISAPPROVAL
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VERONA HIGH SCHOOL
YOUTH VOLUNTEER EVALUATION
(make multiple copies of this blank form if needed)
NAME OF STUDENT SUPERVISOR AT SITE/AGENCY
ORGANIZATION NUMBER OF DAYS VOLUNTEERED
DATE CHECK ONE: Keep this evaluation confidential_
Share evaluation with volunteer
Introduction: Community involvement offers an alternate learning experience for the student volunteer in
which he/she can “try-on” various adult roles while providing vital services for the community. It is our posi-
tion that youth participation should be a major component of a school district’s effort to provide citizenship
education because:
Young people are citizens now, not merely preparing for citizenship;
As citizens, adolescents can contribute significantly to the welfare of their communities;
As adolescents, they benefit from the opportunity to participate as citizens;
Schools can and should facilitate youth participation in community agencies and issues;
School can and should systematically encourage youth people to reflect on their youth participa- tion experiences.
Community agencies accepting youth volunteers are sharing in the citizenship education effort and should:
Provide the volunteer with constructive feedback;
Provide significant tasks for the volunteer which directly meet the genuine needs of the clients served by the organization;
Provide both structure and flexibility - give the volunteer a sense of direction while encouraging
him/her to be responsive to new situations;
Provide the volunteer with decision - making opportunities where the outcome matters to some- one.
Encourage the volunteer to reflect on his/her experiences.
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VERONA HIGH SCHOOL
Name:
YOUTH VOLUNTEER EVALUATION
EVALUATION DIRECTION: Please return evaluations to Mr. Robert Maher, Community Service
Coordinator
For each of the qualities below, circle a number on the scale which coincides with your estimate of
the volunteer’s ability or performances. There are thirteen numbers on the scale. An “N” indicates
no opportunity to observe the student on the quality; 12-10 = superior to excellent performance;
9-7 = excellent to above average performance; 6-4= average performance; 3-1 = below average per-
formance; 0 = failure to perform at a minimum level.
1. ATTENDANCE 12 11 10 9 8 7 6 5 4 3 2 1 N
NEARLY ALWAYS ATTENDS ATTENDS MOST
OF THE TIME
INCONSISTENT
ATTENDANCE
2. ACTION ON 12 11 10 9 8 7 6 5 4 3 2 1 N
ABSENCE ALWAYS NOTIFIES IN NOTIFIES AFTER THE FAILS TO
ADVANCE FACT NOTIFY AGENCY
3. PRODUCTIVITY 12 11 10 9 8 7 6 5 4 3 2 1 N
PERSEVERES IN DIFFICULT WORKS WELL AT JOBS QUITS AT FIRST
TASKS THAT INTERESTS HIM/HER OBSTACLE
4. COOPERATION 12 11 10 9 8 7 6 5 4 3 2 1 N
WORKS WELL WITH STAFF/ WORKS SATISFACTORILY UNCOOPERATIVE
SUPERVISOR WITH OTHERS
5. WILLINGNESS 12 11 10 9 8 7 6 5 4 3 2 1 N
TO LEARN READILY OR ACCEPTS ACCEPTS HELPS SOMEWHAT IGNORES NEEDED HELP
& IMPROVE HELP WHEN APPROPRIATE GRUDGINGLY OR IS OVERLY
DEPENDENT UPON HELP
VERONA HIGH SCHOOL
YOUTH VOLUNTEER EVALUATION
6. SPEAKING 12 11 10 9 8 7 6 5 4 3 2 1 N
SKILLS EXCELLENT GOOD POOR
7. PROBLEM 12 11 10 9 8 7 6 5 4 3 2 1 N
SOLVING EXCELLENT GOOD POOR
8. RELATING 12 11 10 9 8 7 6 5 4 3 2 1 N
TO PEOPLE EXCELLENT GOOD POOR
9. SELF 12 11 10 9 8 7 6 5 4 3 2 1 N
MOTIVATION EXCELLENT GOOD POOR
10. SEEKS 12 11 10 9 8 7 6 5 4 3 2 1 N
CHALLENGES OFTEN OCCASIONALLY NEVER
11. CURIOSITY 12 11 10 9 8 7 6 5 4 3 2 1 N
HIGH INTERMEDIATE LOW
The overall opinion of the work done by student:
EXCELLENT VERY GOOD SATISFACTORY
BELOW AVERAGE UNSATISFACTORY
Comments (Optional):
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VERONA HIGH SCHOOL
EVALUATION OF PLACEMENT
(make multiple copies of this form if needed)
NAME SITE
INSTRUCTIONS:
The following list describes some possible features of a work experience. Please describe
particular experience by circling the appropriate number from 1 to 5.
Practically
Never
Once In A
Great While
Sometimes
Fairly
Very Often
1. I have enough work
to keep me busy.
1
2
3
4
5
2. What I do is interesting.
1
2
3
4
5
3. I find my task challenging.
1
2
3
4
5
4. I am given enough
training to do my tasks.
1
2
3
4
5
5. I do things myself instead
of just observing.
1
2
3
4
5
6. I have adult responsibilities.
1
2
3
4
5
7. I am learning qualities that
will help me in my future
employment or education.
1
2
3
4
5
8. I am given clear directions.
1
2
3
4
5
9. I have a variety of tasks to 1 2 3 4 5
do at the site.
10. Adults at site take a 1 2 3 4 5
personal interest in me.
VERONA HIGH SCHOOL
EVALUATION OF PLACEMENT
Practically
Once In A
Sometimes
Fairly
Very Often
Never Great While
11. I have freedom to 1 2 3 4 5
develop and to use
my own ideas.
12. I feel I am helping 1 2 3 4 5
people or improving
community.
13. My job is just busy work. 1 2 3 4 5
14. I think the site is a safe
place to work.
1
2
3
4
5
15. I am appreciated when
I do a good job.
1
2
3
4
5
16. I get help when I need it.
1
2
3
4
5
17. I discuss my experience
with my supervisor or
co-worker.
1
2
3
4
5
18. I feel I am going a good jo
at this site.
b 1
2
3
4
5
19. I make important decision
s. 1
2
3
4
5
My overall rating of my placement(s) at this point is:
EXCELLENT GOOD FAIR POOR TERRIBLE
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VERONA HIGH SCHOOL
Name:
COMMUNITY SERVICE HOURS LOG
Date Hours Served Service Provided
Supervisor Signature: 15