Wufoo

2008 Learn & Serve Challenge Activity Registry

This is my form. Please fill it out. It's awesome.

Contact Name * Title First Last Suffix
Street Address *

Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Phone * - (###) - ### ####
Email *
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

2008 Learn & Serve Challenge Activity Registry

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