Cover Page

Request for the Service-Learning Label or Course Enhancement Funds

INSTRUCTOR Information:

Name
Department
Phone number
E-mail address

COURSE Information:

Course number
Course title
Next TWO semesters course will be offered
Expected enrollment
(Potential) cross-listed departments
Status / New course
I have taught this course before.
Course has been taught by another instructor.
Will other instructors teach this course (in other sections, or other semesters)?
Directors of Undergraduate Studies:
I support the applicant’s proposal and his/her plans to teach the above-named service-learning course.
Director of Undergraduate Studies (DUS) signature: Date:

Submit to Assistant Director, Duke Service-Learning:

Mail: Box 90739 I Fax: 919.660.3080 I E-mail:


Part 1: Request for the Service-Learning Label

Please tell us how your course will meet the four criteria for the service-learning label below. (Note: It is not necessary to have fully formed answers to all of these questions at this time.)

1.  Students engage in a minimum of20 hoursof planned service activities.

What type(s) of service experiences are you hoping to arrange for your students, leading to the 20 hours of service? What community partners have you approached, or are you considering? (Our office is happy to help identify potential partners.)

Please describe how you will work collaboratively with community partners to ensure that the service-learning experience is mutually beneficial.

2.  The service experience isintegrally relatedto the academic subject matter of the course.

How will the service-learning experience relate to the major learning objectives for your course (knowledge, attitudes, skills, dispositions)? Examples of learning objectives potentially related to service-learning

3.  Coursework involvescritical reflectionon the relationship between academic course content and the service experience.

4.  Coursework involves critical reflection on theethical and civic dimensionsof the service experience.

How will you prepare students for their service experience (e.g., readings, discussions, speakers, training, site orientations)? For examples, see http://servicelearning.duke.edu/faculty/planning-resources.

What assignments and activities will you use throughout the semester to help students critically reflect on how the service experience connects to the academic objectives of the course, and on the ethical and civic issues related to their service? For examples, see http://servicelearning.duke.edu/faculty/planning-resources.

How can we support you?

One of the most important functions of Duke Service-Learning is to support faculty and staff involved in service-learning courses. You will be added to our mailing list and will receive updates, announcements, and invitations to our professional development opportunities. Please let us know how else we can help:

Consultation: I would like to meet with a faculty consultant to discuss (e.g., potential community partners, assessment).

Service-Learning Assistant: I am interested in having a graduate or undergraduate assistant assigned to my course to help with such tasks as community partner placements, student reflections, and research. (Applications will be distributed after registration opens.)

Service-Learning Faculty Fellows Program: I am interested in applying for the Service-Learning Faculty Fellows Program. (Applications will be distributed at a later date.)

Course enhancement funds: I am not requesting funding at this time, but may submit a request for funding (Part 2 below) at a later date (prior to the end of the course). I understand that requests will be considered on a rolling basis until funding is exhausted.

Other:

Applicant signature

In order to support a thoughtful approach to integrating service-learning into undergraduate courses, and to assist with our record-keeping, we ask that those requesting the service-learning designation:

·  Endeavor to deepen their understanding of service-learning pedagogy. Please consider meeting with one of our consultants, and/or attending one or more of our faculty workshops.

·  Share your syllabus with us, after the start of the semester. We will not share (or critique) your syllabus without your permission.

Please sign to confirm that you plan to meet these expectations.

______Date: ______

How did you hear about the service-learning label?

Colleague:

E-mail from Trinity College

Duke Service-Learning newsletter

Other:


Part 2: Request for Course Enhancement Funds

Course Enhancement Funds: Up to $1000 may be requested in conjunction with new requests for the service-learning label. Funds may be requested at this time or at a later date (prior to the end of the course). Requests will be considered on a first come, first served basis until funds are exhausted.

Examples of acceptable budget items include supplies, field trips, presentations, refreshments, staff or student course support, research, conference attendance, and professional development. Please see these guidelines re: transportation, food, and honoraria.

Proposed Budget (Attach additional information if necessary.)

Item / Cost Estimate / Explanation/Breakdown of Cost Estimate
Example: Meal with community partners / $200 / 20 people @ $10 for lunch.
Total

Explanation

In one page or less, please describe the proposed use of funds or elaborate on the nature of your request. How will the funds support the service-learning component of the course?

What other funding sources have you explored, or do you plan to explore?

If funding is awarded, in what ways/venues will the support of Duke Service-Learning be acknowledged? (Sincere thanks for your acknowledgement. Awareness of the work of our office is fundamental to ensuring our long-term viability and continued funding from the University.)

Please note that all Duke Service-Learning funds are offered on a one-time basis.

Business Manager signature

Please sign to confirm that:

·  The applicant has access to a Duke account where grant funds can be deposited and managed. (Supplemental payments will not be issued.)

·  The applicant’s plans are compatible with departmental infrastructure and do not duplicate services or items available through departmental budgetary processes at this time.

______Date: ______

Print/sign

Cost object to which funds should be deposited: ______

Applicant signature

We ask that those requesting service-learning course enhancement funds:

1.  Participate in our gathering of data on community partners and contact information

2.  Provide a short narrative of how you spent or will be spending the funds

3.  Acknowledge the support of Duke Service-Learning in any presentations, media, articles, events, and publications related to the course.

4.  Tell Dane & Miriam about any events going on as part of your class and contribute photos, quotes, or opportunities to write short stories about your class whenever appropriate

5.  Continue looking for sources of other funding to lessen demand on Service-Learning funds

6.  As possible, participate in our learning community by attending workshops and events sponsored by Duke Service-Learning

Please sign to confirm that you plan to meet these expectations.

______Date: ______

Connecting Civic Engagement to the Curriculum