Service-Learning Registration 2015 Fall Question Title * 1. Student ID Number Question Title * 2. Last Name Question Title * 3. First Name Question Title * 4. Email Question Title * 5. Phone Number (Where you can actually be reached) Question Title * 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. Instructor's Name (Last, First) Course Code/Number (ie: SO200) Course Title (ie: Intro to Sociology) Question Title * 7. Are you doing Service-Learning for more than one instructor? Yes No Question Title * 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. 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) Question Title * 9. Student Information Age Gender Ethnicity/ies Major Number of years at Chaminade Question Title * 10. Class Standing Freshman Day Undergraduate Sophomore Day Undergraduate Junior Day Undergraduate Senior Day Undergraduate PACE Graduate Student Question Title * 11. Languages spoken FLUENTLY other than English Lang 1 Lang 2 Lang 3 Question Title * 12. Have you done Service-Learning at Chaminade before? Yes No Question Title * 13. Have you done Service-Learning at any other school? Yes No Next >>