ABSLProgram_FacultyFellowApplication

Academic Service-Learning Faculty Fellows Application

Thank you for your interest in the Academic Service-Learning Faculty Fellows Program. Please complete the questions below. If you are unsure, please indicate this since you are not required to have a service project or community partner prior to the program.

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* 1. Name

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* 2. Phone Number

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* 3. Email Address

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* 4. College or School

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* 5. Department

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* 6. Please indicate if your Academic Dean endorses your participation in the
Academic-Based Faculty Fellows Program.

I have discussed my participation in the Academic Faculty Fellows program with my Academic Dean. My academic dean
supports my participation in the program.

I have not discussed my participation in the Academic Faculty Fellows program with my Academic Dean.

I have not discussed my participation in the Academic Faculty Fellows program with my Academic Dean but my Academic
Dean does support my participation in the program.

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* 7. Please include a course or list of courses for which you would like to develop or integrate academic service-learning.

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* 8. If you have a community partner or placement in mind, please identify this
placement and indicate where it is located.

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* 9. Please describe a possible service-learning project for your course and how your students and community partner(s) may benefit from the service learning experience.

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* 10. Please discuss why you are interested in learning about the development and teaching of academic service-learning courses.

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* 1. Name

Question Title

* 2. Phone Number

Question Title

* 3. Email Address

Question Title

* 4. College or School

Question Title

* 5. Department

Question Title

* 6. Please indicate if your Academic Dean endorses your participation in the Academic-Based Faculty Fellows Program.

Question Title

* 7. Please include a course or list of courses for which you would like to develop or integrate academic service-learning.

Question Title

* 8. If you have a community partner or placement in mind, please identify this placement and indicate where it is located.

Question Title

* 9. Please describe a possible service-learning project for your course and how your students and community partner(s) may benefit from the service learning experience.

Question Title

* 10. Please discuss why you are interested in learning about the development and teaching of academic service-learning courses.

* 6. Please indicate if your Academic Dean endorses your participation in the
Academic-Based Faculty Fellows Program.

* 8. If you have a community partner or placement in mind, please identify this
placement and indicate where it is located.