Activity Write Up

Name

Email

Select a Grade Group

Pre-K - K 1st - 3rd 4th - 5th 6th - 8th 9th - 12th

Name of activity

Date of Activity

Time of Activity

Number of Attendees

Thrusts (choose all that apply)

Select All Character Building Cultural Educational Health Social and Civic

Leadership Modules

Select All Character building Self-confidence Self-discipline Trust and Respect

Activity Host Mothers

Brief Summary and Purpose of Activity

Description of Community Service activities*

Number of Community Service Hours

List names of all participants (children)*

Activity Picture (maximum of 3 pictures)

About us

Chartered in July 1962, the Suffolk County Chapter of Jack and Jill of America, Inc. is a membership organization of mothers with children ages 2 – 19, dedicated to nurturing future African American leaders by strengthening children through leadership development, volunteer service, philanthropic giving and civic duty.

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