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Sample Forms and Templates

This collection of sample documents is designed to provide ideas and templates for creating your own forms without starting from scratch. Please customize them and adapt them to fit your own needs. Samples are contributed by service-learning practitioners.

DISCLAIMER: These documents are only samples—they are not endorsed or approved by the Corporation for National and Community Service or the National Service-Learning Clearinghouse, and they have not been reviewed for compliance with program or funding regulations, or for accessibility.

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Agency Information Form

This 2-part form is designed for agency staff to fill out in order to be listed in a community partner database....
Service-Learning Rubric #2

This rubric may be used to assist service-learning practitioners in measuring the performance of a service-learning...
Service-Learning Rubric #1

This rubric allows service-learning practitioners to assess and evaluate facets such as curricular links, links to...
Youth Program Feedback Survey

This survey, designed for younger participants of a watershed service-learning program, collects feedback on youth...
Partner Feedback Survey Instructions

These instructions are written for use with the Partner Feedback Survey, with steps from obtaining and administering the...
Partner Feedback Survey

This survey is designed to collect feedback from community partners on the benefits of collaborating with youth on a...
Instructions for Administering Older Youth Program Feedback Survey

These instructions are for those administering an older youth program feedback survey-- from obtaining and distributing...
Older Youth Program Feedback Survey

This survey, designed for use after a watershed ecology service-learning program, allows older youth participants to...
Community Service-Learning Advisory Council

A mission statement and description of the roles and responsibilities for the L'Anse Creuse Public Schools Community...
Advisory Goals Checklist

This checklist may be used during the planning and execution of a service-learning project. Sections included involve...