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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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LEARNING Impact Measurement Instrument (watershed restoration)

This impact measurement instrument is for use with a watershed restoration project. Space is given to list the academic...
LEARNING Impact Measurement Instrument (student)

This form, intended for student use, allows students to identify the academic goal and community need prompting their...
Methods and Strategies for Community Partner Assessment

This 11-page "End-of-Program Survey" for community partners is intended to describe the perspectivesand...
Student Post-Service Survey

This two-page survey is designed to measure general attitudes and perceptions of service-learning students. This...
Academic Service Learning Kickoff Letter

A letter from administrators to teachers, kicking off service-learning projects for the academic year. Teachers must self...
Application Addendum

An addendum designed to be attached to an application for program funding, should substantial changes that might have an...
District Application for Service-Learning Funding

Application for a school district wishing to obtain funding for service-learning programs from its state education...
School/Classroom Application for Service-Learning Funding

Application for an individual classroom or school wishing to obtain funding from its state department of education for...
Service-Learning Assessment Reporting Form

This two-page document is meant for faculty teaching designated service-learning courses that need to collect assessment...
Mid-year Progress Report

This mid-year progress report template collect basic data from grantees about college student service-learners,...