Application for Presidential Volunteer Service Award
Award Year Sept.1 2022 to Aug.31 2023
Submission Deadline: Oct.31 2023

Name
Parent Name (if under 18)
Contact Email (can be parent's)
Contact Phone (can be parent's)
Date of birth
Bala Shruti member since (year)
Bala Shruti Volunteer Hours
Total Volunteer Hours

Please tabulate your hours in the following form. You may summarize related activities for the same organization into one line (give the range of dates in that case eg. Jan 1 to May 31) For all non Shruti Laya hours, you must either (1) request your activity coordinator to send an email to pvsa@shrutilaya.org clearly showing your name and how many hours you accumulated or (2) obtain a certificate or other written official document showing your name and hours, and send it by email to pvsa@shrutilaya.org

Date(s)	Activity	Benefitting Organization	Hours Volunteered

I certify that I meet the Volunteer Award Eligibility Criteria listed at http://www.presidentialserviceawards.gov/terms, and that the hours listed on the next page are a true record of time that I actually spent volunteering.

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