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The Agapé Center for Service and Learning

Service-Learning Course Proposal Form


Below you will find a short service-learning course proposal from that will take approximately 5 - 10 minutes to complete.

Please make sure that you complete each of the following three steps so that the Service-Learning Committee can approve your proposal.
1. Complete the following Service-Learning Course Proposal Form
2. Email a MS Word copy of your proposed syllabus to the Director of the Agape Center for Service and Learning
3. Review the Memo of Understanding which your Community Partner will sign upon approval


Course name:
School or area in which course is offered:
Sponsoring faculty member:
Faculty ID number:
Community partner:
If your students will be working through the Agape Center Outreach Teams rather than a particular community partner, please check here:
Proposed as a course offering for:
(The deadlines for securing signatures from the Department Chair, School Dean, and Service-Learning Committee are October 3 for Spring courses and March 1 for Fall courses. The Agapé Center will forward the list of approved courses each semester to the registrar.)

Spring 2009
Fall 2009
Spring 2010
Fall 2010

1. The three components for all service-Learning courses are listed in the Service-Learning Course Parameters. Please provide a brief narrative statement for each component indicating how this course will facilitate the student’s fulfillment of these components.

Content (More Information):


Service (More Information):


Reflection (More Information):
2. Include a narrative description of the course to demonstrate that students will be informed that this course employs service-learning.
3. Do you anticipate any additional expenses for this course?
Yes
No

If you answered "yes" to the above, formulate a preliminary budget that will demonstrate that the cost to students will cover expenditures.
4. Provide a short personal narrative which can serve the Committee in assuring that the sponsoring faculty member satisfies the criteria on faculty expertise included in the fifth structural parameter of the Service-Learning Course Parameters.
5. Is this service-learning experience required or optional?
Required
Optional

6. Please attach and send a MS Word copy of your syllabi to the Director of the Agape Center for Service and Learning to demonstrate that the course is consistent with the structural parameters stipulated for service-learning courses (Service-Learning Course Parameters). Preview Sample syllabi.
By checking these boxes, I verify that I have completed each of the following:
Completed this Service-Learning Course Proposal Form in full.
Emailed a MS Word copy of syllabus to the Director of the Agape Center for Service and Learning.
I have reviewed and affirm the Memo of Understanding (local or national and international) to be mutually agreed upon by my community partner(s).


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