Please use the following process when filling out the Service Learning Project form:
 
1.  Complete by CCS School Personnel Only.
2.  Complete at the end of the Service Learning Activity and no later than June 1, 2013.
3.  This data will be used to measure CCS Strategic Objective 3.3.1 : "By 2011, all Cabarrus
County Schools' service learning activities will positively impact students and community."






Items denoted with a red asterisk * are required.
Service Learning Project Form:
 
Please use this form to tell us more about your student's service learning project.
 * Person Submitting Information
 
First Name
M.
Last Name

First Name / Last Name
 * School Name
 
Phone Number
 
 -  - 
(XXX)-XXX-XXXX
Email Address
 
 * Name of Project
 

Name of Service Learning project
 * Today's Date:
 
Click to View Date Picker

DD/MM/YYYY
 * Project Start Date:
 
Click to View Date Picker

DD/MM/YYYY
 * Project End Date:
 
Click to View Date Picker

DD/MM/YYYY
Service Learning Activity is:
 
Club/Organization Name:
 
Individual or Group Project:
 
If other please specify:
 
 * Total # of Students Involved:
 
If applicable, please state the partnering community agency:
 
 * Curriculum Area Link:
 
 * Activity Goal:
 
 * Activity Description:
 
Activity Highlights:
 
 
 
Please enter the total number of hours involved in this activity (include, planning, implementation & reflection)
-------------------------------------------------
Round up to the nearest hour.
 * Total # Activity Hours:
 
 
 
Teacher Reflection
 * How do you think this service made a difference to your students?
 
 * How do you think this service made a difference in your community and/or those served?
 
 
 
On a scale from 1 to 5, where entering "1" would represent your lowest rating and "5" as your highest; please rate this activity on the following questions:
 * Did this activity meet the set goal?
 

recognized choices:1, 2, 3, 4 or 5
 * How meaningful was this activity to students?
 

recognized choices:1, 2, 3, 4 or 5
The "Captcha Verification" Below is "Case Sensitive". Please enter the text exactly as it appears.
 
 
Header
Text Box
 

Please enter the text
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