Volunteer/Service Hour Submission
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Email *
NAME (First Last) *
Student Email Address *
(double check for accuracy)
Graduation Year *
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NSD Student ID Number *
I am submitting these hours for: *
National Honor Society / KEY Club
NHS and KC strive for our members to give back to their community.  We value student leadership in service and for what it teaches us and how we can put others first.  We desire all members in our separate clubs to be honest in their submission of hours and have implemented the following sheet to keep track of hours.  Although separate organizations, we will use the same form so students do not "double dip" in giving less.  Being a part of one or both means that community service should be authentic and valid.  Thank you for your honesty in advance.  Please fill out this form each time you need to submit an event.  You are still REQUIRED to fill out a sheet manually to keep track of your hours - that will include your contacts signature for verification.

For questions please email:
Honor Society - Chikako Misener: cmisener@nsd.org
Key Club -        Kelley McKay: kmckay@nsd.org
Total Number of hours I am submitting (It's due May 6th, 2022) *
Event 1: Name, Date(s) and hour(s) -Please combine all hours for this event (Example: Online Tutoring, 7/18/21, 8/23/21, 9/4/21, 10/3/21,  2 hours a session, total 8 hours) *
(xx/xx/xxxx format)
Event 1: What was your role at this event? What did you do? Provide detail. *
Event 1: Contact Name  for Verification *
(Include first and last)
Event 1: Email Address and phone number of Contact for Verification *
Event 1: Comments / Notes:
Anything we need to know to clarify this event?
Event 2: Name, Date(s) and hour(s) -Please combine all hours for this event
Event 2: What was your role at this event? What did you do? Provide detail.
Event 2: Contact Name for Verification
(Include first and last)
Event 2: Phone Number and email address of Contact for Verification
Event 2: Comments / Notes:
Anything we need to know to clarify this event?
Event 3: Name, Date(s) and hour(s) -Please combine all hours for this event
Event 3: What was your role at this event? What did you do? Provide detail.
Event 3: Contact Name for Verification
(Include first and last)
Event 3: Phone Number and email address of Contact for Verification
Event 3: Comments / Notes:
Anything we need to know to clarify this event?
Event 4: Name, Date(s) and hour(s) -Please combine all hours for this event
Event 4: What was your role at this event? What did you do? Provide detail.
Event 4: Contact Name for Verification
(Include first and last)
Event 4: Phone Number and email address of Contact for Verification
Event 4: Comments / Notes:
Anything we need to know to clarify this event?
Event 5: Name, Date(s) and hour(s) -Please combine all hours for this event
Event 5: What was your role at this event? What did you do? Provide detail.
Event 5: Contact Name for Verification
(Include first and last)
Event 5: Phone Number and email address of Contact for Verification
Event 5: Comments / Notes:
Anything we need to know to clarify this event?
If you need more than 5 events, please email me at cmisener@nsd.org
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