APPLICATION & CONTRACT

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1 APPLICATION & CONTRACT Deadline for Application: Monday, September 26, 2011 ** Must meet with CSL /Practicum Coordinator by Monday, September 19, 2011 ** Contact Ellen Correa Community Service Learning Practicum: The Community Service Learning Practicum (CSL Practicum) is a mandatory pass/fail course for 1-6 credits in which students engage in meaningful service in the community and learn from that service through weekly reflections and a final paper or project. Students complete at least 30 hours of service for each credit (i.e., 30 hours for one credit, 60 hours for two credits). Students develop their learning goals in consultation with their faculty sponsor and meet with the faculty sponsor, for a total of eight hours over the course of the semester. The student and community supervisor are expected to meet for a minimum of two hours during the semester. The student writes regularly in his/her reflection journal and shares these periodically with the faculty sponsor during meetings. The student typically writes a final paper which reflects on the service experience. The student and the faculty sponsor may also define an alternative summative project. The faculty sponsor will assign a pass/fail grade based on the student s demonstration of learning, fulfillment of service hours, completion of the goals outlined in the CSL Practicum contract, the student s evaluation of service placement, and the community supervisor s evaluation. Service Component and Community Supervisor: Students are encouraged to identify relevant service opportunities in consultation with their faculty sponsor. For additional assistance securing a community service placement contact the CSLHIS/Practicum Coordinator at the Community Engagement Program office (610 Goodell). The handout Guidelines for Students Calling Organizations is available to assist with contacting community organizations. In an effort to ensure adequate training and support for the community service experience, students must have a community supervisor at their service site. Students should consult with their community supervisor on their CSL Practicum application. Near the end of the semester, the community supervisor completes an evaluation of the student and submits it to the Community Engagement Program, which forwards the evaluation to the faculty sponsor. Note that academic credit is not for the service itself, but for what students learn from the service. In order to build a relationship with the community organization and to benefit from reflection which takes place over an extended period, the student s service hours should take place over the course of the semester. Service hours which take place in a compressed period of time, for example, one week or weekend, are not appropriate for CSLHIS. Service hours should be completed by the end of the semester in which the student is registered in the CSL Practicum.

2 Orientation and Reflection Sessions: Students enrolled in CSL Practicum will attend two sessions with other CSLHIS/Practicum students. The first session provides an orientation to community service learning as well as an opportunity for students to further define their goals and meet other CSLHIS and CSL Practicum students. In the second session students will have the opportunity to reflect on their service experiences, address any challenges, and develop their ideas for final papers or projects. Applicants rank their dates of preference on the attached application in the space provided. Participation in the two sessions is mandatory and will be considered in the course grade. Deadlines and Details: Students are encouraged to begin the application process early. In order to increase the likelihood that a proposal will meet the CSLHIS requirements, students are encouraged to meet with the CSL Practicum Coordinator to discuss their application. The deadline for meeting with the CSL Practicum Coordinator is Monday, September 19, Completed applications, and any necessary course change request forms, must be submitted to the Community Engagement Program, 610 Goodell, by Monday, September 26, Applications will be reviewed and students will be notified of their status. Applications that are received without a preliminary meeting will be reviewed on a case-by-case basis. Additional details regarding the application process are on the attached Student, Faculty and Community Guidelines.

3 APPLICATION AND CONTRACT (Copies will be mailed to the student, faculty sponsor, and community supervisor.) STUDENT INFORMATION Student Name Major Class Year: Sr. Jr. Soph. Fr. Local Address Phone ( ) Student ID# FACULTY INFORMATION Faculty Sponsor Name Department Campus Address Phone ( ) Fax ( ) Faculty ID# (REQUIRED) COMMUNITY SUPERVISOR INFORMATION Community Supervisor Name Organization Name Organization Address Phone ( ) Fax ( ) CREDITS AND SERVICE HOURS Semester (circle one): Fall Spring Year: Credits (circle one): (Number of credits is determined with faculty sponsor, with 30 contracted hours of service for each credit. When will your service begin? Anticipated Number of WEEKLY service hours: This application/contract is the official record of your CSL Practicum. Grad schools, employers, etc., inquiring about your CSLHIS may be sent a copy of your proposal; ensure that it is well written and an accurate reflection of the integration of service and learning in your independent study.

4 Attach a 1-2 page proposal that answers the following questions: 1) Describe the service you will do with the community organization. Include in your answer: Where you will be working What kind of work you will be involved in Who you will work with (service recipients, organizational staff, other community members) Who will supervise your work Why you are interested in doing this work 2) What knowledge and skills do you hope to learn from this experience? What methods will you use to fulfill your learning goals? Please describe your initial ideas for a final paper or project. REFLECTION SESSIONS Rank each set of reflection sessions in your order of preference: e.g. 1 Oct. 13th ; 2 Oct. 11th ; 3 Oct. 12th Tuesday, Oct. 11 th, 4:30-6:00 (Mon. class schedule) Monday, Nov. 7 th, 4:30-6:00 Wednesday, Oct. 12 th, 5:00-6:30 Tuesday, Nov. 8 th, 5:00-6:30 Thursday, Oct. 13 th, 5:00-6:30 Wednesday, Nov. 9 th, 5:00-6:30 Student: I have read and understand the CSL Practicum Contract and Guidelines. I agree to complete the number of service hours indicated, write in my reflection journal, meet regularly with my faculty sponsor, and submit a final paper or project. Through this service experience I plan to address the learning goals as outlined in my contract. Student Signature Faculty Sponsor: As this student s faculty sponsor, I accept his/her service plan and learning goals. I agree to review his/her reflection journal and meet regularly with the student for a total of eight hours to help him/her, to help facilitate learning from the service experience.. Faculty Sponsor Signature Community Supervisor: As this student s community supervisor, I approve this service plan as both feasible and useful to my organization. I think the learning goals are reasonable, and I agree to supervise this student, meet with him/her for at least two hours over the course of the semester to reflect on the service, and complete an evaluation. Community Supervisor Signature FOR OFFICE USE ONLY: TERM: COMMENTS: COURSE: CREDITS: CLASS #: APPROVED BY: DATE:

5 STUDENT, FACULTY, AND COMMUNITY GUIDELINES Prior to the Application Deadline: Student meets with the CSL Practicum Coordinator to review application process by Monday, September 19, Set up an appointment by contacting the CSL Practicum Coordinator at or visit 610 Goodell. Student communicates with faculty sponsor and community organizations to identify a community placement (with the help of CEP if needed). Student reviews all attached materials with the community supervisor. Student and faculty sponsor develop learning objectives and any additional course requirements for the semester in communication with the community supervisor. Student completes CSL Practicum Application/Contract and submits it to CEP by the application deadline (Monday, September 26, 2011). If applying after the end of the Add/Drop period, student completes Course Change Request (CCR) form and submits it to the CEP with the application. (Pre-Major students whose contracts will be processed after the Add/Drop period should be sure to submit a Late Course Add Petition in addition to all other contract materials.) The following fields must be completed by the student on the CCR form: Student Name, Student I.D. Number, Primary Major, Level,, Student Signature. The faculty sponsor signature must also be provided. The application is reviewed by CEP staff and the student is contacted regarding the application status. If accepted, CEP enrolls the student. Student should check his/her SPIRE schedule to verify that the course has been listed. Late Adds can take several weeks to appear in SPIRE. During CSL Practicum: CEP provides the following resources: student guidelines for service, reflection journal guidelines, resources for completing the final paper, and introductory materials on service learning pedagogy. Student participates in service. Expectations include: prompt, regular attendance, a positive attitude, respect for the organization (including staff and clients), fulfillment of outlined responsibilities, and a desire to learn. Community supervisor clearly identifies reasonable service hours, explains the organization s goals and the student s role in working toward those goals, provides adequate training for assigned tasks and offers the guidance and supervision provided to volunteers in the organization. The student and community supervisor are expected to meet a minimum of 2 hours during the semester. Community supervisors are encouraged to contact the faculty sponsor or CEP with any questions or concerns. Student keeps weekly reflection journal (2-3 pages per week). CEP sends reflection journal guidelines to the student when they are accepted to the program. Student and faculty sponsor meet regularly to reflect on the community service experience and its link to academic matter for a minimum of 8 hours over the course of the semester. The reflection journal should be submitted and discussed during these meetings. End of the Semester: Student submits a final paper or project to the faculty sponsor by the due date determined by the faculty sponsor. The final paper/project should reflect on the service experience and address the learning goals outlined in the CSL Practicum contract as well as additional learning. Community supervisor returns the student evaluation form (sent in advance) by the deadline indicated on the form to CEP. CEP then forwards a copy to the faculty sponsor. Student returns the Student Evaluation of Service Placement form to CEP that then forwards it to the faculty sponsor. Faculty sponsor evaluates student learning as demonstrated by the reflection journal, meetings with the student, the community supervisor s and student s written evaluations, and the student s final paper/project. Faculty sponsor assigns a pass/fail grade for the CSL Practicum and then responds to grade submission request from Commonwealth Honors College.

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