Exit this survey Copy of Fall Holyoke Bound 2018: Faculty Registration Question Title * 1. Contact Information: Last Name: First Name: Email: Department: Subject: Question Title * 2. School: UMASS Smith College Amherst College Mount Holyoke College Hampshire College Westfield State University Holyoke Community College High School Other Other (please specify) Question Title * 3. Why are you attending Holyoke Bound? Please check all that apply. Require all my students to attend. I am presenting. I am facilitating a workshop. To get a better idea of opportunities in the City of Holyoke for my students. To get a better oriented to the City of Holyoke. A peer, staff or faculty member suggested I attend. Other (please specify) Question Title * 4. Do you teach a designated Community Based Learning/Service Learning course? If you answered "yes," please identify the class and if Holyoke Bound attendance is required for students. Example: Sociology 101 Required Attendance. If you no, please write "not designated." Question Title * 5. If you answered "yes" to question 4, how many students are in your class? Question Title * 6. If you do teach a designated Community Based Learning/Service Learning course or have a community component in your class, what type of community partnerships are/will your students/class be placed with? Elementary school High school Adult education After school programs Government Social service agency/organizations Environmental organizations Public health organizations Other (please specify) Question Title * 7. What is the name of the Community Partner(S)? Question Title * 8. If you do teach a course and would like to add a community component to the course, what type of community partnership would you be interested in building a relationship with? Please select all that apply. Elementary school High school Adult education After school programs Government Social service agency/organizations Environmental organizations Public health organizations Other (please specify) Question Title * 9. How many Holyoke Bounds have you attended? None, this is my first Holyoke Bound 1 2 3 Other (please specify) Question Title * 10. Transportation to Holyoke:Transportation to Holyoke Bound from the Five College campuses is provided. A bus will be picking up students and faculty in the morning. This bus will also bring students and faculty back to their respective campuses. More information about bus pick up times and locations will be emailed to you prior to the event. I am driving my own car (I do NOT need bus or van transportation) Bus from Five College campuses Question Title * 11. Lunch WILL be provided. Do you have any dietary restrictions? Vegetarian Vegan Lactose Intolerant Gluten-Free Other Other (please specify) Question Title * 12. If you may need any disability or accessibility accommodations, please let us know. Next