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