Service-Learning Classroom Experience
Email address *
Name *
Start date of experience *
MM
/
DD
/
YYYY
End date of experience *
MM
/
DD
/
YYYY
Course name *
Instructor's name *
Community partner *
Description of activity *
Critical concern addressed by service: *
Total number of hours you served *
What type of reflection was used for your service experience? *
Did you find this kind of reflection beneficial? *
Please evaluate the following questions: This experience helped me: *
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Not Applicable
learn about people different from myself
become more sensitive to the hardships and needs of others
increase my curiosity about other groups with whom I have not had direct experience
learn how to work more collaboratively with other people on real problems
develop a greater sense of personal responsibility
realize that my life can make a difference
critically reflect upon my own values and biases
understand how communities work or function
develop a greater awareness of societal problems
understand how course material relates to real life settings
think about different fields I may want to work in
How did this service experience affect your classroom experience? *
What changes to the service-learning project would you recommend for the future?
If Fundraiser: How much money was raised? Please indicate total US Dollar ($)
Other comments or feedback
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