Service-Learning Course Designation Form for New Applications and Reapprovals
This form serves as a planning and assessment tool for service-learning at VCU and as a means of ensuring the integrity of VCU’s service-learning courses. In addition to basic course and instructor information, the form gathers information about the four major components of a service-learning course: service experience, syllabus, reflection and the final evaluation.

The service-learning course designation process includes 2 easy steps:

Step 1: Complete this form.
Section 2: Email course syllabus to Katie Elliott ( immediately after you complete this form. Syllabus must include the VCU Statement of Service-Learning.

Please note that approved courses retain their service-learning designation for three years, after which we ask faculty to apply for reapproval and provide updated information. This form is used both for applications for new service-learning courses and for those seeking reapproval for an existing service-learning course that is due to renew its designation.
Section 1: Instructor and Course Information
Instructor's Name *
Instructor's Email *
VCU Department/Unit *
Semester course is taught *
Check all that apply
During which semester will this class first be offered as a service-learning class? *
Semester, Year
Course Title
Subject Prefix *
(e.g., for PADM 609, enter PADM)
Course Number *
(e.g., for ART 302, enter 302)
Section Number
If you know the section number, please enter it here. If there are multiple sections, separate them with commas (e.g., 001, 002)
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