Faculty Application
Name____________________________________ Date_________
Office extension_______________ E-mail address_________________
Semester that you will begin using Service Learning_________________
Courses in which you will incorporate Service Learning:
_______________________________________________________
_______________________________________________________
If you would like, when would there be a convenient time for you to meet with the Service Learning Director for assistance?__________________________________________
Would you want the Service Learning Director to present a Powerpoint presentation on Service Learning to your class? (Circle one) Yes / No
If yes, when and where is the class?_______________________
Attach a syllabus incorporating the Service Learning component, including connection to the objectives, reflection activities, grading criteria, and due dates.
