SERVICELEARNINGAGREEMENT
LastName FirstName ID#
E-mailAddress______ServiceStartDate______EndDate______
Please note: the dates listed about are the actual dates for the course. Details for actual service learning hours will be arranged by both parties and implemented within the contract once agreed upon.
AgencyName______SiteContact______Phone #______
CourseNumber Professor Phone #______
Brief Description of Service: ______
WhatisService-Learning?
“Service-learningisaphilosophyofexperientiallearning[integratedintoandenhancingacademiccurriculum]inwhich
studentsparticipateincommunityservicenotonlytomeettheneedsofthecommunity,butalsotodeveloptheircritical thinkingskills,commitmenttovalues,andskillsforeffectiveleadership.”
MintzLiu,1994
TheService-LearningAgreementisdesignedto:
♦ Assistthestudentandagencyinunderstandingthelearningobjectivesforthecourse.
♦ Clarifytheactivitiesinwhichthestudentwillbeinvolvedattheagencyinrelationtothe
learningobjectives.
♦ Ensurethatboththestudentandtheagencyareawareoftheresponsibilitiesaspartnersin
thisservice-learningproject.
PartI:LearningObjectives:(Tobefilledoutbythestudent)
CourseObjectives:
Pleaselistthelearninggoalsprovidedbytheinstructorforthiscourse that will be met with this project.
Student’sPersonalLearningObjectives:
Pleasedescribethreelearninggoalsforyourworkatthisagency.Theseshouldrelatetothecoursegoalsprovidedbyyour
instructorand toyourownpersonalexperienceand development.
PartII:AgencyActivities: (Tobefilledoutbycommunityagencysupervisor)
Pleasedescribetheworkthatwillbecompletedduringthisservice-learningprojectand howitcontributestotheagency.
PartIII:IntegrationPlan:
Howwillyou(student)connectyouractivitiesin theagencytoyourcoursecontentand viceversa?
PartIV:Responsibilities:
As aservice learnerIagree to:
- Attend anorientationatmysiteandservetheagreedupontimeforthedurationofthesemester
- Call mysite if I am unable tomakemynormalscheduledtime
- Actinaprofessionalmannerwhenattendingmy site
- Filloutandreturnpaperworkwithindesignatedtimeframe
- Notifymysite contactifI am havingproblemswithmysite,ornotifymyprofessorifproblemscannot beresolvedbytalkingtothesitecontact
- Keeptrackofmyhoursthroughoutthesemesterontheapprovedservicelearningtimesheet
StudentSignature Date
As acommunitypartnerwiththe Service LearningProject at UCO Iagreeto:
- Provideathoroughorientationanddiscusslearningobjectiveswithservice learners
- Placestudentsinvolunteer situationswhichwillbecomplementary to their classwork
- Beavailableto theservice learners tolet them knowofthingssuchas agencycalendarandspecialevents
- Providefeedbackontheservicelearner’sperformance
SiteContactSignature Date
AsaprofessorusingservicelearningIagreeto:
- Review contract to insure course objectives and service activities are appropriately matched
- Provideguidancetohelpstudentsrelatetheirvolunteerexperiencetotheir class work
- Check inwithstudents to makesureservice experiences aregoingwell
- Communicatewiththecommunity partner duringthe semester
- Helpstudents reflectontheirservice andsocietal issues theyencounter
ProfessorSignature Date
Makethree copiesofthisform whencomplete:
1.Student
2.Agency/organizationsupervisor
3.Professor
Created April 2014 by
Dr. Lori Risley
Assistant Professor,Service Learning Scholar,
Adult Education & Safety Science Dept.
University of Central Oklahoma
100 N. University Dr., Box 120, Edmond, OK 73034
405-974-5533
We are all diamonds in the rough until polished, how can I help you shine?