Pre-Service-Learning Group Placement Contract

Are you a BCC faculty member who has a group of students in one service-learning placement? If so, please complete the Pre-Service Learning Group Placement Contract, and click submit.

This Pre-Service Learning Group Placement Contract must be submitted before the end of the fourth week of classes or before students start their service placement if that is earlier.

Semester:

Course Information:

Course:

example: PSY165

Section:

example: A2W

CRN

example: 15423

Instructor Name:

First Initial: Example: Zahm M.

Email:

Community Partner Placement Information:

Organization:

Department:

Address:

City:

State:

Zip:

First Name:

Last Name:

Title:

Phone:

Ext.

Email:

Service-Learning Activity:

Please describe the activities the students will undertake as part of their Service-Learning project:

Describe your reflection assignment:

Expected project span:

Start Date:

(MM/DD/YYYY)

Finish Date:

(MM/DD/YYYY)

Please list student names and corresponding BCC IDs: