Instruction Sheet

Student Application: Be sure to list FOUR places that need volunteers. You do not have to volunteer at these places, just identify them.  Be sure to have your parent/guardian sign the bottom portion.

Agency Application: Choose someplace at which to volunteer and have someone in an authority position fill out the form. Put your name and year of graduation on the top of the form.

Volunteer Service Record: Keep the log sheet and start filling it out. When it is full, make a copy of it for your records and turn in the original to the Guidance Office. Pick up blank log sheets as needed. It is your responsibility to make copies of your log sheet for your service club sponsors. Copies will not be made in the Guidance Office.

Staple and return all of the forms to Mrs. Sasser’s mailbox  as soon as they are completed. REMEMBER, ALL FORMS MUST BE TOTALLY COMPLETED BEFORE THEY WILL BE ACCEPTED AND BEFORE YOU BEGIN YOUR SERVICE HOURS.


  • All high school students are eligible to participate in this program.
  • Applications must be approved before service hours will be accepted. All applications must be turned in before May 1st. This includes seniors needing credit for graduation or Florida Bright Futures eligibility.
  • Students must perform volunteer services on their own time and may not perform such service during a regular class period or regular school day.
  • Students may not receive academic credit or be paid for services rendered.
  • Course-based service learning activities may be counted toward community service hours and Bright Futures Scholarship program (2009 Legislature, SB 1248, Section 2.Section 1003.497, Florida Statute).
  • Volunteer hours may be counted for the Florida Bright Futures Scholarship Program requirements and Honor/Awards and High School credit.

Hours that CANNOT be counted:

  • Service performed for pay
  • Church-specific activities done during church services
  • Work done for relatives
  • Work done during school hours
  • Court-ordered community service
  • Work part of a high school credit work program (DCT, OJT, Career Prep, etc.)
  • Work done as an extension of class (TV Productions, Drama, etc.)
  • Performances where admissions is charged
  • When purpose of performance is to promote the sponsoring organization
  • When sponsoring organization receives payment for performance
  • Job shadowing
  • Service related to armed services recruitment requirements
  • Work done for companies that operate FOR PROFIT.

Florida Bright Futures Scholarship Program: Students wishing to meet the Florida Bright Futures Scholarship requirements must serve a minimum of 30 approved community service hours for Florida Gold Seal Vocational Scholars Award, 75 hours for Florida Medallion Scholars, or 100 hours for Florida Academic Scholars in addition to meeting the other requirements. They must also complete a written plan.

  • All participants with 10-49 hours (accumulated in one year only): certificate
  • All participants with 50-99 hours(accumulated in one year only): certificate w/ embossed seal
  • All participants with 100+ hours (upon initial accumulation only): silver pin (sponsored and awarded by Academic Booster Club)
  • All SENIORS with 250+ TOTAL hours will receive a silver cord and medallion to wear at graduation.
  • All Seniors with 1000+ total hours will receive the Exceeding Expectations Medallion.

High School Credit Program:

  • Students may receive ½ elective credit for each 75 hours of service (up to maximum of 1 credit)
  • Hours may be accumulated throughout the student’s high school years
  • Seniors must have application forms turned in by May 1st to receive credit for graduation.


  1. Before serving hours, students should review the Student Progression Plan and register by completing the Student Application and Parent Approval Form and submitting it to our Community Service Coordinator.
  2. Guidance counselors will direct students seeking credit or participating in the Florida Bright Futures Scholarship Program for the Academic Scholars’ Award Program.
  3. Application must be made before March 1 of the student’s senior year.
  4. Students must also have a Record of Volunteer Service Hours Form. This is to be filled out by the student and signed by the coordinator and organization where the student volunteers.
  5. The Community Service Coordinator has authority to verify or deny hours served.
  6. Code of Conduct and School Board rules apply while the student is performing community service hours.

The principal of the school has the authority to dismiss a student from the Community Service Program.

Serving Hours:

  • Students may serve hours during the summer proceeding the 9th grade year if a student has registered and completed the Student Application and Parent Approval Form and logs their hours on the Record of Volunteer Service Hours Form.
  • Service hours earned during regular school hours require prior approval from the Community Service Coordinator.
  • Family members may not sign off on hours served.
  • Service to individuals must be conducted through and be verified by an eligible agency.

Hours that count:

United Way agencies, nonprofit agencies, Special Olympics, school volunteer programs, Chambers of Commerce, political action, nursing homes, hospitals, museums, libraries, and service club activities that provide benefit to the community.

Hours that cannot be counted:

Regular meeting times for extra-curricular activities and clubs, Saturday School or any detention/work detail, court ordered service, time served in the Executive Leadership Program and Exploratory Teaching Program, church activity related to worship and evangelization, school music or dramatic productions when used for credit, service performed for pay, service related to armed services recruitment requirements, babysitting, for profit organizations, veterinarian and physician’s offices.

Parent/Guardian Volunteers:

The Polk County School Board has an outstanding volunteer program, with over one million service hours donated by more than 30,000 volunteers each year.

English Volunteer Application | Spanish Volunteer Application | Haitian Creole Volunteer Application

The security of our students is a primary concern. Volunteers pay a one-time, non refundable fee of $25.00 to cover the cost of a Florida Department of Law Enforcement background check. Payment is made by certified check or money order payable to the Polk County School Board and submitted with a volunteer application at the school site. Volunteer approval is continuous from year to year and applies to all Polk County Schools. Check and make sure you are not already approved.

For more information about volunteering for the Polk County School Board, you can visit the PCSB Website.