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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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Service-Learning Start-Up Faculty Survey

Survey for faculty to indicate involvement with and interest in community service activities connected with course...
Service-Learning Option Assessment Feedback

Form for instructors to provide feedback on how the service-learning component affected their course. Contributed by:...
Learning Objective Assessment/Accomplishments Log

This simple grid is for recording learning objectives, evidence of achievement, date of completion, and what is left to...
Integrating Service and Academic Study Oral Survey

This one-page preliminary survey is to ascertain a faculty member's familiarity with and interest in service-learning as...
Faculty Questionnaire

One-page form for faculty to give feedback on their service-learning experience by rating various aspects on a scale from...
Faculty Service-Learning Component Assessment

One-page feedback form for faculty to fill out. Evaluates the addition of the service-learning component to course...
Faculty Community Service-Learning Evaluation

One-page survey for faculty to rate the effectiveness of the service-learning experience in their classes. Contributed by...
Employee Service Project Survey

The Employee Service Project (ESP) at Brevard Community College allows full-time employees to perform community service...
Community Partner Questionnaire

This two-page survey lets community partners evaluate their experience with student workers and with the service-learning...
Multiple Sample Awards

This 13-page document shows sample text and design for various awards. Included are campus-specific awards, student...