Community Service List - Pre-Approved Agencies and Monthly Hours Requirements

Sep 16, 2026

Uploaded by Noah

Community service hour submission requirements for a municipal court program, including rules for using pre-approved agencies, completing work that must be supervised, and filing separate forms per agency. Details monthly hour reporting expectations and specifies when written authorization from the judge is required. Provides a pre-approved agency list with contact information and example task types, plus a community service log sheet template for recording dates, times, completed hours, locations, supervisor initials, and total hours.

LanguageEnglish

CategoryForms

FormatPDF

Pages2

Reading Time1 min

AccessFree to download

Pre-approved community service agencies

When authorization is required

Community service log sheet (monthly hours)

Community Service List ➢ IF THE AGENCY IS NOT LISTED ON THE PRE-APPROVED LIST BELOW, YOUR HOURS WILL NOT BE ACCEPTED UNLESS YOU RECEIVE WRITTEN AUTHORIZATION FROM THE JUDGE. ➢ You must submit a separate form for each agency you completed work for. ➢ Hours must be filed monthly ➢ Community service work must be supervised and cannot be supervised by or work completed for a family member. ➢ If you are unable to complete your hours with an agency listed below, you must submit a letter to the Judge containing: 1. A statement of why you are unable to complete your hours from the Pre-Approved List. 2. The registered 501c3 non-profits agency name and address of where you want to complete your hours. 3. The authorized Supervisor’s name and phone number for the agency you are requesting to complete your hours at. 4. A list of tasks you will be completing for them. Pre-Approved Community Service Agencies | Agency | Phone \# | Contact | Work Examples | | --- | --- | --- | --- | | Bremerton Foodline | (360) 479-6188 | CSW Coordinator | • Sorting, Packing
• General Labor | | City of Poulsbo Public Works | (360) 779-4078 | CSW Coordinator | • General Labor
• Janitorial
• Vehicle Washing | | Coffee Oasis – Bremerton
Coffee Oasis – Kingston Coffee Oasis – Port Orchard Coffee Oasis – Poulsbo | (360) 377-5560
(360) 881-0314
(360) 602-0407
(360) 598-2091 | CSW Coordinator | • General Labor
• Janitorial | | Kingston Food Bank | (360) 297-4861 | CSW Coordinator | • General Labor
• Sorting
• Packing | | Kitsap County Habitat for Humanity | (360) 479-3853
(360) 377-1800 (Store) | CSW Coordinator | • General Labor/
• Janitorial
• Minor Carpentry
• Light Clerical | | Kitsap Humane Society | (360) 692-6977
Ext. 1119 | CSW Coordinator | • General Labor
• Janitorial
• Kennel Cleaning | | Martha & Mary Nursing Health & Rehab Center | (360) 394-4019 | CSW Coordinator | • General Labor
• Light Clerical | | North Kitsap Little League | (360) 731-3181 | CSW Coordinator | • General Labor
• Field Maintenance
• Minor Carpentry | | North Kitsap Pee Wees | (360) 265-3443 | CSW Coordinator | • General Labor
• Field Maintenance | | Port of Poulsbo | (360) 779-9905 | CSW Coordinator | • General Labor
• Janitorial
• Grounds Maintenance | | Poulsbo Fire Department | (360) 779-3997 | CSW Coordinator | • General Labor
• Vehicle Washing | | Salvation Army
(No DV cases, Assaults or Thefts) | (360) 373-5550 | CSW Coordinator | • Kitchen Help
• General Labor
• Janitorial
• Light Clerical | | South Kitsap Helpline | (360) 876-4089 | CSW Coordinator | • General Labor
• Sorting
• Packing | | St. Vincent De Paul – Bremerton St. Vincent De Paul – Port Orchard | (360) 377-2929 Ext. 3
(360) 876-6933 | CSW Coordinator | • General Labor
• Cleaning | LOJ Hours by Hours Sentence Condition LOF $ Hours ($13 .69 per hour) Community Service Log Sheet – Poulsbo Municipal Court HOURS MUST BE FILED MONTHLY Name: Case \# | Date | Time in | Time Out | Hours
Completed | Location | Supervisor’s Initials | | --- | --- | --- | --- | --- | --- | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | TOTAL HOURS | | | | | | Under penalty of law, I swear or affirm that I represent a non-profit organization and that the individual above did complete the community service hours as indicated above. Supervisor’s Signature Print Supervisor’s Name Organization Name Phone \# Type Of Work Done: Dated:

FAQs

What happens if the agency is not on the pre-approved list?

Hours will not be accepted unless the judge grants written authorization.

How should community service hours be submitted across multiple agencies?

Submit a separate form for each agency where work was completed.

What information must be included in the letter to the judge when an agency isn’t pre-approved?

Include why the hours can’t be completed from the pre-approved list, the 501c3 agency name and address, the authorized supervisor’s name and phone number, and a list of tasks to be completed.

Sep 16, 2026

Uploaded by Noah