<p> Service Learning Faculty Interest Form</p><p>Thank you for your interest in service learning programs at Philadelphia University. This form was developed with three purposes in mind: 1) to begin the process of working together in your service learning course objectives; 2) to help you summarize your ideas about service and community-based learning components; 3) to help Community Service Learning staff know how to best collaborate with you regarding these activities.</p><p>Using this form as a starting point, we will work with you to develop a program that will fulfill the objectives of your course and develop an effective and beneficial project for students, local non-profit organizations, and faculty. It will also help the Community Service Learning staff accommodate the increased growth and interest in service learning pedagogy without sacrificing quality and without placing a “last-minute” burden on our staff.</p><p>This form should take no more than 10 minutes to complete and is enormously helpful to us. Please return these forms at least one month before the start of the semester if you wish to collaborate with Community Service Learning to include a service learning component in your course.</p><p>Date: ______</p><p>Name: ______</p><p>Email: ______Phone: ( ) ______</p><p>Dept: ______Office: ______</p><p>Course Name: ______</p><p>Course Description: </p><p>Please attach a course syllabus, even if it has not been updated to include service learning assignment. Please return to: For more information, please contact: Student Development Programs Aurélio Mnauel Valente Community Service Learning [email protected] Kanbar 311 215-951-2634 4201 Henry Avenue Philadelphia, PA 19144 Please describe your learning objectives for the service/community-based learning component of your course: 1. ______2. ______3. ______</p><p>How do you plan to assess your students’ work in your service learning course? (we can help you develop this aspect of the project if you are not sure)</p><p> Journal  Reaction Paper  Oral Presentation  Portfolio  Research Paper  Other: ______</p><p>The social issues you want the service learning experience to address include:</p><p> Education  Environment  Hunger/Homelessness  Arts  Health  Multicultural issues  Elderly  Immigration  Children  Special needs  Family  Other:  Mental health ______ Women/Gender Issues ______</p><p>The time requirement you will request of your students is approximately:  Fewer than 10 hours per semester  hours per semester  hours per week  Not sure if there will be a minimum, as the assignment is project-based and will vary</p><p>The service learning/community-based work in this course be:  Required  Optional  An optional alternative to a required assignment  Decision pending</p><p>Notes/Comments: </p><p>Thank you for filling out this informational form. We will be contacting you shortly to discuss collaborating on your service learning program.</p>