Service-Learning Registration 2012 Spring

 

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1. Student ID Number

Student ID Number

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2. Last Name

Last Name

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3. First Name

First Name

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4. Email

Email

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5. Phone Number (Where you can actually be reached)

Phone Number (Where you can actually be reached)

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6. Your Instructor/s must approve your Service-Learning activities for credit in each specific course. The connection of service with academics is key. If you have secured approval, please enter your course information here.

Your Instructor/s must approve your Service-Learning activities for credit in each specific course. The connection of service with academics is key. If you have secured approval, please enter your course information here.   Instructor's Name (Last, First)
Course Code/Number (ie: SO200)
Course Title (ie: Intro to Sociology)

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7. Are you doing Service-Learning for more than one instructor?

Are you doing Service-Learning for more than one instructor?   Yes No

8. If you are doing Service-Learning for more than one course, be sure that EACH instructor knows about ALL the other courses for which you’re “counting” your S-L activities. They may require additional assignments/hours. Enter additional courses here.

If you are doing Service-Learning for more than one course, be sure that EACH instructor knows about ALL the other courses for which you’re “counting” your S-L activities. They may require additional assignments/hours. Enter additional courses here.   2nd Instructor's Name (Last, First)
2nd Course Code/Number (ie: SO200)
2nd Course Title (ie: Intro to Sociology)
3rd Instructor's Name (Last, First)
3rd Course Code/Number (ie: SO200)
3rd Course Title (ie: Intro to Sociology)

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9. Student Information

Student Information   Age
Gender
Ethnicity/ies
Major
Number of years at Chaminade

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10. Class Standing

Class Standing   Freshman Sophomore Junior Senior Graduate Student

11. Languages spoken FLUENTLY other than English

Languages spoken FLUENTLY other than English   Lang 1
Lang 2
Lang 3

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12. Have you done Service-Learning at Chaminade before?

Have you done Service-Learning at Chaminade before?   Yes No

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13. Have you done Service-Learning at any other school?

Have you done Service-Learning at any other school?   Yes No