St. Cloud State University
Service-Learning Time Sheet

Student Name: 				
Course: 						Semester:					
Agency: 						Agency Supervisor: 				

AGENCY REP
DATE		HOURS	ACTIVITIES						INITIALS

				

				

				

				

				

				

				

				

				

				

				

Date Completed: 				Total Number of Hours: 		
Final Site Supervisor Signature: 							

For information about this course, please contact <Professor, phone/email>

For more information regarding service-learning at St. Cloud State University, please call Volunteer Connection at (320) 308-3898.