Please complete the following information. For your convenience, in some boxes we have pull down choices.
NOTE: Enter the information correctly. Upon entering your campus user name, and clicking the submit button at the end of the form you will receive a confirmation sent to your email address. This confirmation is to be printed and signed by your instructor. If you do not receive the e-mail confirmation, it means that the information entered was wrong.
Make sure to complete this form once you obtain ALL information required such as site supervisor's name, email address, ect.
Questions with * means that the information is required in order to submit registration
Thank you for submitting the Student Service Learning Plan. This confirms that the information you submitted has been delivered to the Office of Civic Engagement.
To continue the process, print this confirmation, and obtain required signatures at the bottom of this document. Remember, signatures are required to be original and in BLUE ink! If your service learning course is an online class, please visit your professor during their office hours. If your professor is not available or is out of town, please ask who is the signature designee, and obtain their signature.
IF the organization in which you are doing your service is NOT on the Service Learning database, ask for your instructor's for approval and submit a Student Field Placement Procedure form and provide the agency's information, you may do so by clicking on the link below:
The service learning forms Student Service Learning Plan and Participation Guidelines are to be submitted with original signatures to the Office of Civic Engagement in Craven Hall 6105.
Student Signature: __________________________________________Date: ________________
I have reviewed and approve the Student Learning Plan set forth above.
Faculty Signature: __________________________________________Date: ________________