Application for Service Learning Designation

Service-Learning Course Designation Application

Name Name * First Last
Email *
Date Date * / MM / DD YYYY
Course Number *
If applying for multiple classes, please list additional course numbers and names (ex: ENGL 2025, Fiction: ENGL2000, English Comp)
College/School *
Department *
Department Chair *
Department Chair Email *
Will participation in the service-learning portion of the course be required or optional? *

Will participation in the service-learning portion of the course be required or optional? Required Optional
Have you selected a community partner, or would you like assistance in making a connection? If you have partner(s), please provide the name and contact information. Provide a general description of the partners along with detailed information about how you choose them each semester. *
Have you determined the community-identified need(s) that will be addressed by this course? *
What reflection methods will students use throughout the semester to help them connect the service learning projects to the academic course content? *
How will you determine the degree to which the community partner needs have been impacted? *
Syllabus with Service Learning Component

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