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Pi Mu Phi Military Sorority
Tennessee Queens Court

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Community Service Form

First & Last name

Organization Name

Supervisor name

Address

Phone

Time Spent for Community Service

Time

:HoursMinutes

I affirm that the individual above performed the above duties for community service.

Signature

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Signature field is empty.

Call us:

931-249-6776

Find us:

3404 Bradfield Street

Clarksville, TN 37042

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