CSL Community Service Learning Homepage, University of Massachusetts Amherst

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Fourth Credit Option in Community Service Contract,

Department of Anthropology, UMass Amherst

4TH CREDIT CHECK LIST

___1. check with your instructor to see whether she/he will accept the fourth credit option.

___2. find a service placement relevant to your course and fill out section I of the contract.

___3. bring the contract to your professor and have her/him fill out section II.

___4. bring contract to Professor Keene who will keep a copy and give you the schedule number for Anthropology 397s (Community Service).

___5. add one credit of Anthropology 397s

___6 complete minimum of 30 hours community service and any additional requirements specified by your professor. Enjoy the experience. Think about how communities work. Think about how your experiential learning relates to your in-class activities.

___7. attend mid-semester evaluation meeting on (ADD DATES_______________). ATTENDANCE AT THIS MEETING IS MANDATORY IN ORDER TO RECEIVE CREDIT.

___8 keep a journal during your service in which you reflect on what you are doing and how it relates to what you are doing and school , what you want to do with your life, and what you know about the society in which you live. (attache guidelines for journal writing)

___9. have your field supervisor fill out the field evaluation form and return it to your professor.

____10. write your reflective essay (directions attached) and turn it in to your professor.

ANTHROPOLOGY 397S-FOURTH CREDIT OPTION

CONTRACT

PLEASE TYPE OR PRINT NEATLY. THIS CONTRACT MUST BE COMPLETED AND FILED WITH PROFESSOR KEENE BEFORE THE LAST DAY OF ADD/DROP. NO LATE ADDS WILL BE PERMITTED.

SECTION I: FIELD PLACEMENT INFORMATION

TERM/YEAR _____________

NAME_______________________________ STUDENT #_________________

MAJOR______________________________ YEAR_______________________

COURSE IN WHICH FOURTH CREDIT OPTION IS BEING ADDED

COURSE #____________________ COURSE NAME______________________

AGENCY/ LOCATION WHERE YOU WILL DO YOUR SERVICE:

NAME:

ADDRESS:

PHONE #:

NAME OF CONTACT PERSON:

BRIEF DESCRIPTION OF DUTIES:

BRIEF DESCRIPTION OF HOW THIS SERVICE RELATES TO YOUR COURSE: WHAT DO YOU HOPE TO LEARN FROM THIS EXPERIENCE:

NAME OF FIELD SUPERVISOR (IF DIFFERENT FROM CONTACT PERSON):

STARTING DATE: ___________

FIELD SUPERVISORS STATEMENT:

THE ABOVE NAMED STUDENT HAS ARRANGED TO DO A MINIMUM OF 30 HOURS SERVICE AT OUR AGENCY BETWEEN ________ AND ___________.

_________________________________________

SIGNATURE OF FIELD SUPERVISOR

SECTION II: PROFESSOR'S PERMISSIONS

I HAVE DISCUSSED THE PROPOSAL LISTED ABOVE WITH THE STUDENT NAMED ON THE CONTRACT AND I AGREE THAT IT IS APPROPRIATE FOR MY COURSE. I GRANT PERMISSION TO ELECT AN ADDITIONAL CREDIT OF ANTHROPOLOGY 397S.

_________________________________________

SIGNATURE OF PROFESSOR

I HAVE SPECIFIED THE FOLLOWING ADDITIONAL READING, WRITING, REPORTING REQUIREMENTS BEYOND THOSE SPECIFIED IN THE STANDARD CONTRACT. (IF NONE WRITE NONE).

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FIELD SUPERVISOR'S EVALUATION:

DEAR SUPERVISOR: THANK YOU FOR TAKING A FEW MINUTES TO FILL OUT THIS EVALUATION. YOUR STUDENT VOLUNTEER NEEDS IT TO COMPLETE HER/HIS COURSE OBLIGATIONS. YOU MAY MAIL THIS EVALUATION DIRECTLY TO ME AT THE ADDRESS BELOW OR YOU MAY GIVE IT TO YOUR STUDENT VOLUNTEER IN A SEALED ENVELOPE.

STUDENT'S NAME______________________

SEMESTER ______________________________

1. DURING THE TERM HOW MANY HOURS OF SERVICE DID THE STUDENT PROVIDE?

2. WHAT WERE THE STUDENT'S PRIMARY DUTIES?

3. DID THE STUDENT FULFILL THEIR DUTIES IN A RESPONSIBLE MANNER? WAS THE STUDENT DEPENDABLE?

4. WOULD YOU ACCEPT THIS STUDENT AS A VOLUNTEER IN YOUR AGENCY AGAIN?

5. IS THERE ANYTHING ELSE THAT YOU WOULD LIKE TO SHARE ABOUT THIS STUDENT?

6. ARE YOU INTERESTED IN FURTHER COOPERATION WITH OUR DEPARTMENT? DO YOU HAVE ANY SUGGESTIONS ON HOW WE MIGHT FACILITATE FUTURE COLLABORATIONS WITH YOUR ORGANIZATION?

MAIL TO: