2017 – 2018Service Learning Application

(due Friday, May 12th, 2017 to Mrs. Kennedy or the middle school office)

Last Name: ______First Name:______Current Team:______

***______I have read my child’s application and support his or her decision to apply.***

(parent signature)

Select your 1st choice, 2nd choice, and 3rd from the Service Learning Groups.

Student Self-Evaluation

Rate yourself in the following areas:

Rating Scale of 1-5: (1 = low, 5 = high)

___ Most people describe me as organized.___ I like to meet new people.

___ I am dependable…I follow through on tasks.___ It is easy for me to be friendly.

___ I CARE about my grades.___ People describe me as outgoing.

___ I would make a good homework helper.___ I care about the school and community.

___ I enjoy helping others.___ I am a patient person.

___ I respect people of all abilities & backgrounds.___ I am a good listener.

___ My grades are always C’s and above.___ Given a chance, I enjoy being a team leader.

___ I am comfortable speaking to large groups. ___ I can initiate and complete tasks on my own.

___ I can follow any type of leader. ___ When someone needs help, I offer right away.

___ Other people believe I am a positive person. ___ I am comfortable mediating a conflict.

___ Teachers would say I am a mature person. ___ I will positively represent WMS inside and

___ I am loyal; I am willing to donate time outside outside of school. (Integrity)

the regular Life 101 block of time.___ To help others, I am willing to participate in things

___ I use humor appropriately and at appropriate times. that might stretch my comfort level.

The following questions should be completed by ALL applicants.

All Service Learning students are asked to journal often to reflect on service activities and personal growth. The questions below are similar to journal reflection activities of Service Learning students.

Share WHY you are interested in Service Learning:

When I see a student sitting alone at lunch, I typically…

When I observe two students arguing in the hall, I typically…

When I notice a classmate is unhappy, I typically…

List in-school and out-of-school activities (& number of years) in which you participate:

What have you contributed to your school, community or peers in previous years? How have you served?

Please share any helpful insight about yourself that helps Service Learning sponsors in making this decision. What makes YOU the best candidate?

Student Signature ______

Magic Me

(*In addition to the above questions, thoseapplying for Magic Me, please complete this section.)

What inspires you to want to be involved in Magic Me and work with seniors or those who are handicapped? Do you have experience?

Suggest a NEW project or activity to implement when working and visiting with those living in senior care centers: