Community Involvement Hours Record Form

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Record of Community Involvement Hours
Please review the Ministry of Education guidelines on the reverse for eligible
and ineligible activities before doing your community involvement hours.
Name: ______________________________
Please Print
Activity:
Community Organization Name and Address:
Hours Completed:
Sponsor Name (printed):
Student Signature:
Sponsor Signature:
Parent Signature:
School Official Signature:
(If student is under 18)
(For school office use only)
Name: ______________________________
Please Print
Activity:
Community Organization Name and Address:
Hours Completed:
Sponsor Name (printed):
Student Signature:
Sponsor Signature:
Parent Signature:
School Official Signature:
(If student is under 18)
(For school office use only)
Record of Community Involvement Hours
Please review the Ministry of Education guidelines on the reverse for eligible
and ineligible activities before doing your community involvement hours.
Name: ______________________________
Please Print
Activity:
Community Organization Name and Address:
Hours Completed:
Sponsor Name (printed):
Student Signature:
Sponsor Signature:
Parent Signature:
School Official Signature:
(If student is under 18)
(For school office use only)
Name: ______________________________
Please Print
Activity:
Community Organization Name and Address:
Hours Completed:
Sponsor Name (printed):
Student Signature:
Sponsor Signature:
Parent Signature:
School Official Signature:
(If student is under 18)
(For school office use only)
COMMUNITY INVOLVEMENT
Halton Students Contributing to their Community
Eligible activities are ones that:
are of benefit to the community
may support a not-for-profit agency, institution or foundation that conforms to the ethical standards of
Halton DSB, Halton CDSB, and the Ministry of Education
promote tutoring, mentoring, visiting or coaching
support ethical work of a global nature
promote positive environmental awareness
support clubs, religious organizations, arts or cultural associations, or political organizations that seek to
make a positive and ethical contribution in the community
Specific areas of involvement may Include:
Fundraising
School Community Service
Work with Animals
Youth Programs
Community Events and Projects
Arts and Culture
Committee Work
Environmental Projects
Office/Clerical Work
Religious Activities
Volunteer Work with Seniors
Activities for Individuals
Ineligible activities, based on Ministry of Education and School Board policy include:
course requirement
activities during school hours (except lunch break or spare periods)
logging or mining environment (if student is under 16)
factory work (if the student is under 15)
workplaces other than a factory (if the student is under 14 and is not accompanied by an adult)
duties that would normally be performed for wages by a person in the workplace
operation of a vehicle, power tools, or scaffolding (e.g. snow blower, power mower, hedge trimmers, etc.)
the administration of any type or form of medication or medical procedure to other persons
handling of substances classed as “designated substances” under the Occupational Health and Safety Act
(e.g. asbestos, lead, dangerous chemicals, toxic materials, etc.)
regulated trades work
banking, the handling of securities, jewelry, works of art, antiques, or other valuables
duties normally performed in the home or personal recreational activities
court-ordered activities
activities that provide direct financial benefit or gain to the students or to the student’s immediate family
work with any organization which does not comply with the ethical standards, policies, procedures or
regulations of the Ministry of Education, Halton DSB and the Halton CDSB
simple membership in a school or community club
activities that are part of a Community Service Day during regularly-scheduled class time (e.g. Terry Fox
Walk)

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