Online Completion Form for Service Learning

Online Completion Form Service Learning

All students participating in Service Learning MUST fill out this online form once their service hours have been completed every semester. Students MUST ALSO turn in copies of the Service Learning paperwork (agreement form and time-sheet) to their professor for their completed hours to be documented and validated with Palomar College.

First Name*
Last Name*
Student ID Number*
Phone Number
Email Address
Enter Email Confirm Email
Course Information
Semester (example: Spring 2020, Summer 2020)*
Course Department and Number (example: CHDV 115, SOC 100)*
Class Number (example: 79224, 12345)*
Is this a class requirement or optional?*
PROFESSOR'S NAME - Your Teacher's Name*
Put your Teacher's name here. First and Last name only. DO NOT put your name here! Put your Teacher's name!!
Professor's email address
Enter Email Confirm Email
Service Completed
Name of Organization*
Name of Your Supervisor*
Program Name and or Volunteer Role*
examples may be: Preschool assistant, classroom volunteer, food distribution, etc.
Hours of Service Completed*
Please enter a number from 0 to 200.
list the total number of hours completed during the current semester
You can earn a Service Learning Certificate of Achievement for completing a minimum of 15 service learning hours in a semester.
- Yes - I am interested in a certificate.
- No - I am not interested in a certificate.
Are you going to continue volunteering with your Service Learning organization?*
Would you recommend this site to another Service Learning Student?*
Were you offered a job or internship with your Service Learning Organization?*
Evaluation of the Service Learning Experience
Your feedback helps us find the best placement for Service Learning Students in our community. Data from this section will be used anonymously and not directly reported back to the organization/agency at which you served.
What course concept(s) did you learn in the classroom that you applied at your service site?
My service learning experience motivated me to complete the course.*
My service learning experience increased my appreciation for community involvement and helping others.*
My service learning experience increased my knowledge about working with diverse communities.*
My service learning experience helped clarify my future career interests/goals.*
Every student should have to complete a Service Learning project in order to graduate.*
How has your service learning experience affected the way you view your college experience?
Please Share Any Additional Feedback on your Service Learning Experience

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Service Learning

Service Learning

Online Completion Form for Service Learning

Online Completion Form Service Learning

Course Information

Service Completed

Evaluation of the Service Learning Experience

Contact Information

Service Learning

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