OCDSB 716 Curriculum (April 2012) Page 1 of 2
COMMUNITY INVOLVEMENT NOTIFICATION AND ACTIVITY COMPLETION SHEET
Student Name
Student ID No.
Principal
School
Telephone
Community involvement hours completed to date
Student’s Signature Date Parent’s or Guardian’s Signature Date
Please provide the information requested below about the community involvement activities in which you are involved. Approval of the principal or designate is required
before starting the activity.
Activity Number of Hours Completion
Date
Location Phone Number Supervisor’s
Signature
Principal / Designate’s
Signature
Office Use Only
Estimated Actual DD/MM/YY C.I. Hours noted in
OSR
NOTE: Please submit this form to the school when you have completed the community involvement activities described above. Submit no later than January 8 and June 8 each term so that hours can be
recorded on the upcoming report card.
Personal information on this form is collected under the authority of the Education Act and Municipal Freedom of Information and Protection of Privacy Act, and will only be used to document completion of
community involvement hours. The information on this form is confidential and access will be limited to those employees who have an administrative need, the student, and parent(s)/guardian(s) of a student
who is under eighteen years of age. Questions regarding this collection are to be directed to the school principal.
OCDSB 716 Curriculum (April 2012) Page 2 of 2
COMMUNITY INVOLVEMENT NOTIFICATION AND ACTIVITY COMPLETION SHEET
Examples of Community Involvement Activities
The following list is not exclusive but contains some examples of activities that are suitable for
completion of the community involvement requirement.
Not-for-profit Agencies – includes voluntary activities for any not-for-profit institution or
foundation that would not displace a paid worker
For-profit agencies – includes voluntary activities that are charitable-based for any business or
organization that would not displace a paid worker.
Note: Any association with an organization, or an organizations activities, that does not comply with the
ethical standards, policies, procedures and regulations of both the Ministry of Education and the Board are
not eligible for community involvement.
Support for Individuals – includes assistance to those in need with shopping, housekeeping,
writing letters or transcribing, hospital visitation or chronic care
Learning Assistance – includes activities in structured programs that promote tutoring,
mentoring, coaching, reading buddies or whose purpose is to help others that require that
assistance
Ethical Contributions – includes affiliation with a club, religious organization or political
organization that seeks to make a positive and ethical contribution to the community or supports
ethical works of a global nature
Community Projects – includes participating in food drives or supporting groups such as 4H
Clubs, Welcome Wagon...
