Wufoo

Contact Name * Title First Last Suffix
Street Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone * ### - ### - ####
Email *
Did your organization participate in the 2008 Learn & Serve Challenge? *
Yes No Not Sure
Web Site
Share a photo of your school/organization
Which role best describes your position *
Youth (up to age 25) AmeriCorps Member Business Partner/Leader College Faculty College Staff Community-Based Leader/Partner Foundation/Funder Government Official K-12 Teacher Parent/Family Policymaker Program Director Service-Learning Coordinator School District Administrator School Principal State-Level Staff Other
If you selected "Other", please describe
Please tell us how you heard about this opportunity to share your best service-learning story (check all that apply) *
Camp Fire USA Campus Compact Corporation for National & Community Service National Service-Learning Clearinghouse National Service-Learning Partnership National Youth Leadership Council Service-Learning United Email or Website SEANet Voice for National Service Youth Service America Other
If you selected "Other", please describe
Please provide the following basic information about your event/activity:
School/Organization Name *
Title of Your Event/Activity *
Date of Your Event/Activity MM / DD / YYYY
If Your Event/Activity is on-going, please put "on-going" here
Time (if no time, please ignore) HH : MM : SS AM/PM
Please put in the information you have available (Location, City, State, Zip Code+4) *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Estimated Number of Participants *
In 75 words or less, describe your Learn & Serve Challenge event or activity. *

Be sure to mention any goals your school or organization may have for service-learning this year (e.g., We will engage 100 students in service-learning by June 2009 or We will host a public ralley in support of service-learning on October 7, 2008).
Please list all collaborating or participating partner schools and organizations (i.e., xxxx, yyyy, and zzzz).
In 50 words or less, describe how service-learning has influenced or changed the culture of your school or organization (e.g., new partnerships, improved school-community relations, increased enthusiasm among staff and faculty) or how it impacts your community. *
Learn and Serve America is a program of the Corporation for National & Community Service that provides grants to support service-learning in K-12 schools, tribes, colleges, universities, and community-based organizations. Are Learn and Serve America funds used to support your service-learning activities? *
Yes No Don't Know/Not Sure
The Corporation also administers other programs and activities to promote citizen service and volunteerism. Do you partner with any of the following Corporation-sponsored programs? (check all that apply)
AmeriCorps AmeriCorp*NCCC AmeriCorps*VISTA Foster Grandparents RSVP - Retired and Senior Volunteer Program Senior Companions Senior Corps Other
If you selected "Other", please describe
Do Not Fill This Out

Wufoo

Please provide the following basic information about your event/activity: