EmailMe Form - Clark College Service-Learning Hours Report Form

Name *
First Last
Email *
Status at Clark College *
Quarter at Clark College *
Department *
(eg: BIOL, CMST, DH, HDEV)
Course Number and Title *
(eg: 213: Small Group Communications)
Item Number *
(eg: 4476, B184, 4A55, 5709A)
Number of Students that Participated in Service-Learning *
Number of Hours Per Student Per Quarter *
Total Number of Hours Completed *
Community Partners *
(eg: outside nonprofit organizations, Clark College programs and clubs, single events on or off campus, etc.)
Was this your first time offering a service-learning component at Clark College? *
Yes
No
Not Sure
Do you plan to offer a service-learning component in one of your courses at Clark College in the future? *
Yes
No
Not Sure
Any comments you would like to offer?