Creating a Community Service Form?

[Wren]

I am about to finish 10 hours of community service and was told by the person running the program that they do not have a standard form to give me and that I would need to bring something for them to sign. What would need to be listed? Obviously the dates, times, and number of hours worked, and where it was done as well as contact info. Do I need to included the type of work that was done or anything like that? The court did not give me anything to have filled out so I am not sure what they want. I really want to do this right so that it looks proper.