<p>Service-Learning High-Impact Practice Mini-Grant Application</p><p>Faculty/Instructor Name: Enter First and Last Name College & Department: Enter College & Department Email: Enter Email Address Phone Number: Enter Phone Number Course Name, Prefix, & Number: Enter Course Information Semester & Year of Course: Enter Amount Requested: $ Enter Requested Semester and Year Amount Community Partner Name and Contact Information: Enter Community Partner Contact Information</p><p>You may answer the following questions on this sheet, or attach a sheet with your answers:</p><p>1. What are the learning outcomes for your course and how will the service-learning component help you achieve these outcomes?</p><p>Click or tap here to enter text.</p><p>2. Briefly explain how the requested funds will be used, and why these expenses are crucial to the delivery of your course.</p><p>Click or tap here to enter text.</p><p>3. Please indicate with a “yes” or “no” your willingness to do the following:</p><p> a. Collaborate with OCEP on administering deeper assessments of student learning outcomes resulting from your service-learning course: Yes ☒ No☐</p><p> b. Ensure that your department’s scheduler has identified your course as “service- learning” when scheduling information is given to the Registrar: Yes ☐ No☒</p><p> c. Provide material (such as quotations from students and/or community partners; digital photos; video recordings; news stories; press releases) from your class so we can feature it on our website/in our newsletter: Yes☒ No ☒</p><p> d. Include the following acknowledgement in scholarly works resulting from this grant: “This work was supported, in part, by funds provided by the University of South Florida Office of Community Engagement and Partnerships”: Yes ☐ No ☐</p><p>OFFICE OF COMMUNITY ENGAGEMENT AND PARTNERSHIPS University of South Florida • 4202 East Fowler Avenue, ALN 185 • Tampa, FL 33620 (813) 974-4829 • www.usf.edu/engagement • [email protected]</p><p>Building Partnerships to Improve Our Communities e. Make a best effort in seeking other support to sustain the service-learning course in future semesters (e.g., consider adding a course fee to cover expenses associated with service-learning): Yes ☐ No ☐</p><p>● Please include with your application a copy of your syllabus and the letter of support from your community partner (if possible).</p><p>All applications, with course syllabus and community partner support letter, must be submitted electronically to [email protected] by 5:00 pm on the deadline date.</p><p>Service-Learning High-Impact Practice Mini-Grant Budget</p><p>Item Item Quantit Funding Requested Cost Total Category Description y from OCEP:</p><p>Supplies Equipment Travel Other Total project budget:</p><p>Total funding requested from 0 OCEP (not to exceed $5001):</p><p>1 Requests for additional funds may be considered under some circumstances. Please discuss any requests for funding above $500 with OCEP staff before submitting your application.</p><p>OFFICE OF COMMUNITY ENGAGEMENT AND PARTNERSHIPS University of South Florida • 4202 East Fowler Avenue, ALN 185 • Tampa, FL 33620 (813) 974-4829 • www.usf.edu/engagement • [email protected]</p><p>Building Partnerships to Improve Our Communities</p>