Part 1: Partnership Requirements
1. The organization is defined as:
Non-Profit
Health Care
Government
K-12
Other:
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2. Does your organization maintain liability insurance for your volunteers?
Yes
No
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3. Will the students displace an employed worker?
Yes
No
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4. Are there any costs associated with the students? If yes, what are the costs?
Yes
No
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5. Please list any requirements needed for a student to volunteer with your organization? (background check, special training, licenses, certifications, etc.)
Yes
No
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Part II: Community Agency Responsibilities
As a community agency partnering with a service-learning class you agree to the following responsibilities. Please check each responsibility.
Hold UVU’s Volunteer & Service-Learning Center harmless from any liability for loss or damage arising from the acts of omissions of the organization.
Do not involve students in lobbying activities.
Take time to orient the student/class to the agency rules, policies, guidelines, etc.
Designate a staff member to supervise the student and maintain communication with the faculty member.
If the faculty member requires, complete and sign the student agreement and time log sheet. The faculty member will provide you with this.
Meet regularly with the student.
Notify the faculty or the Volunteer & Service-Learning Center if any problems arise.
Offer suggestions and ideas for improvement to the Volunteer & Service-Learning Center, faculty, and student.
Maintain good communication.
Ensure that students do something constructive and worthwhile that will benefit the agency and the student.
Ensure that the service reflects the class objectives.
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Part II: Project Information
Community Agency: |
| Contact Name: |
| Title: |
| Telephone: |
| Fax: |
| E-mail: |
| Website: |
| Address: |
| City: |
| State:
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Zip Code:
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1. What is the mission/purpose of your organization?
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2. Please list the primary population(s) served? (youth, seniors, children, homeless, etc.)
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3. What community need would a service-learning class or student address?
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4. How will the project specifically address this need?
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5. Indicate the number of students requested and the preferred times (weekends, weekdays, afternoons, evenings, mornings, etc.)
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6. Please list and describe the project objectives, related activities, and project outcomes.
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7. Is this project one time or ongoing?
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