Service Agreement for E Learning by ugg18335

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									                           SERVICE LEARNING STUDENT AGREEMENT FORM
                             OFFICE OF STUDENT LEARNING INITIATIVES
                                         TROY UNIVERSITY

To be completed and signed by the Troy University student, community agency supervisor and the Troy University
Faculty Supervisor. This form outlines the duties and responsibilities of the student volunteer participating in service
learning activities through coursework at Troy University.

Please provide the following information:
Student                                                        Student ID:
Phone #:                                          E-mail:
Service-Learning Class (course # and title):                                 Instructor:
Community Agency:                                                   Phone #
Agency Supervisor:                                                 Title:
Phone #                                            E –mail:

The parties hereby agree as follows:
Start Date of Service-learning:                             Final Date of Service-Learning:
Scheduled Days/Times for Student to attend Service-Learning Site:

           Day                Time

           Monday

           Tuesday

           Wednesday

           Thursday

           Friday

           Saturday

           Sunday


Proposed Service-learning tasks and experiences:




Academic learning goals for service-learning experience:
        The Student agrees to follow the Troy University Student Code of Conduct, as outlined in the Oracle and the Troy
        University Catalog and any organizational guidelines set by the community agency.
        The Student agrees to communicate regularly with the community agency, including giving at least 24-hours
        notice to the Community Partner Supervisor if unable to attend on any given day.
        The Student understands that participation in the Service-Learning activity, as detailed above, must meet
        academic standards set by course instructor and any course credit towards final grading must meet guidelines set
        by instructor.
        The Student understands and consents to the liability standards laid out in the Academic Service-Learning
        Liability Standards and Release Form as detailed at: http:www.troy.troy.edu/servicelearning/students
        The Community Partner Supervisor agrees to:
            o Communicate with the Student regarding the expectations and logistics of the service experience
            o Orient the Student to the mission and structure of the organization and train them on the service that needs
                 to be done
            o Provide clear supervision to Student
            o Provide the necessary tools to complete tasks
            o Ensure a safe experience and an environment free of discrimination
            o Verify the Student’s Service-Learning Time Log and complete the Service-Learning Final Evaluation;

Please Sign and Date:

Student:                                                    Signature:                               Date:


Community Partner Supervisor                                Signature:                               Date:


Faculty:                                                    Signature:                               Date:


Parent/Legal Guardian (in case the student is 19 years old or younger):

Name:                                                      Signature:                                Date:



STUDENTS: You must submit signed form to your instructor and to the Office of Student Learning Initiatives, 115
Eldridge Hall by September 3rd, 2010 to receive credit for the Fall 2010 semester.

								
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