Student Name *

First Name

Last Name

Mother Name *

First Name

Last Name

Father Name *

First Name

Last Name

Student Name *

First Name

Last Name

This is to certify that the student listed above has performed volunteer service hours for the date(s) and event(s)/location(s) listed below. *

Please select one box below

Accept and Agree

Decided- Student did not successfully complete any community service hours.

Southern Belles Dance Company Community Service Events 2023 - 2024

Please select all events below that the student attended to receive credit.

City of Little Rock Back 2 School Event August 12, 2023 (Total Hours 4)

Corvettes and Veterans Day Event November 11, 2023 (Total Hours 4)

Jack & Jill GLRC Breakfast with Santa Event December 2, 2023 (Total Hours 2)

UAMS Mid-South Black Expo 2024 February 24, 2024 (Total Hours 4)

South Arkansas Black History Program 2024 February 24, 2024 (Total Hours 8)

Jack & Jill GLRC Pink & Blue Cotillion-Beautillion March 2, 2024 (Total Hours 12)