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2. First Name*
3. Last Name*
5. Address*
7. City*
8. State
9. Zip Code*
11. Phone Number*
12. Email Address*
14. How Did You Earn Your Hours?*

    1. Trash Clean-up
    2. KOB Office Duties
    3. Upcycle Garden Maintenance
    4. We Care, We Help Program
    5. KOB Storage Facilities
    6. KOB Event
    7. Court Ordered
    8. Other
15. Why Did You Need Service Hours?*
    -- Select One --Texas ScholarsCourt AppointedChurchSchoolOther
16. How Many Hours Did You Complete?*

    ***Please Note -  For court ordered community service participants, 1 bag of trash is equivalent to 30 minutes of work.***

17. Are Your Hours Complete?*
    -- Select One --YesNo
19. Documentation:
    • Please attach before and after pictures of your cleanup. 
    • Volunteers:  Make sure all volunteers are in the picture.
    • Court Ordered Community Service:  Make sure all bags of trash collected are in the picture.
20. Please List The Dates & Times You Worked:
    Please List The Dates & Times You Worked: Start Date

    Please List The Dates & Times You Worked: Start Time

    —

    Please List The Dates & Times You Worked: End Date

    Please List The Dates & Times You Worked: End Time
22. Image Upload 1
23. Image Upload 2
24. Image Upload 3
26. Image Upload 4
27. Image Upload 5
28. Image Upload 6
30. Work Description & Details:*

    Trash Clean-up: You must provide us the location of where you cleaned, before & after photos, and how many bags of trash you collected. 

    Worked At The KOB Office OR An Event: Must provide a description of the duties you performed. 

    Worked At The Upcycle Garden: Must provide a description of the maintenance you performed and if you planted plants; provide the number of plants planted and any other gardening details.

    Mowed Yards For We Care, We Help Program: Must provide before & after photos and the number of yards serviced with their addresses.

    Worked At KOB Storage Facilities: Must provide a description of the work you performed.

Leave This Blank:


32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit

* indicates a required field