Sample Proposal Form

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Service Learning Project Proposal
Submit the completed Service Learning Project Proposal to Amoena Norcross at
anorcros@tctc.edu no later than Thursday, November 20, 2014. Refer to the rubric in
this packet as this rubric will be used by the Service Learning Advisory Team to
evaluate and approve proposals. A completed and signed Service Learning Project
Developer Agreement (also in this packet) must also be submitted to Amoena
Norcross in RH-249A no later than Thursday, November 20, 2014.
NAME: Deborah Brock
DEPARTMENT/DIVISION: Medical Laboratory Technology/Health Education
1. Describe what knowledge you have of service learning assignments, activities,
etc. This knowledge may have come from teaching, attending a workshop, or
other sources.
I attended a round table on service learning at the League of
Innovations conference. I attended the two lunch bunch activities in
the spring where aspects of service learning were discussed.
2. Describe the project idea that you would like to explore for a SL project by
providing responses to each section below. If your proposal is approved for
development, the project that is developed should be one that can be ultimately
used by other instructors as well. For example, a SL project developed for ACC
101 should be adaptable by any ACC 101 instructor desiring to implement a
similar project in his/her ACC 101 section(s).
a. List the course(s) that will include the proposed SL project and provide a
preliminary name for the project. Indicate if you will teach multiple sections of the
same course during the implementation semester.
MLT 120 Immunohematology – only one section of this course is taught in
the spring of every year.
09.18.2014
b. Provide the Student Learning Outcome(s) in the course(s) that will be associated
with this SL project.
1. State two reasons for performing donor screening
2. Determine whether to accept or defer a prospective donor when given
donor medical history.
3. Determine whether to accept or defer a prospective donor when given the
results of a donor physical examination.
4. Describe the phlebotomy process for blood donation collection.
c. Explain in detail your SL idea or project.
Students have learning outcomes in MLT 120 Immunohematology relating to
screening prospective blood donors (taking BP, pulse and temperature). While I
usually teach these skills in class and then talk about the donation process, I would
prefer the students experience a blood drive. Therefore, I would like to look into
partnering with a blood donor center to see if students could volunteer to work at
blood drives or in the donor center. I know that they can hand out cookies but I
would like to investigate what other skills they can perform associated with the blood
collection process.
I plan to do the following during the development phase:
1) To further research how to set up a solid S/L project
2) to have conversations with donor centers, either by phone, email or via
conversations at their sites. It will be necessary to determine what the donor center
can show our students (the donation process) and if the students can volunteer in
any way. I am not completely aware of the regulations relating to who can watch
donations and if there are requirements to volunteer at a blood drive.
3) to develop the project schedule and requirements (when in semester, how much
time, grades assignment/activity or extra credit)
d. Provide the names of the potential community partner(s) that you plan to seek
out to work with you on this project.
AnMed blood donor center in Anderson
Blood Center – not sure of their service area
09.18.2014
e. List the campus(es) (Pendleton, Anderson, or Easley) and community area(s)
where the SL project would be carried out.
MLT 120 class is taught on Pendleton Campus. Donor center is in AnMed but blood
drives where students can volunteer will be all over Anderson and Pickens counties.
3. Once your developed SL project is approved by the SLAT, you will be required to
take released time (equivalent to 3 instructional/classroom hours per week)
during the implementation of the SL project in Fall 2015; you will not be permitted
to teach an overload. Describe how it is possible for you to take one course
released time (equivalent to 3 instructional/classroom hours per week) during the
implementation semester. Please consult with your supervisor and submit the
Service Learning Project Developer Agreement in this packet.
I have discussed this request with my department head (availability form
is signed and attached). At the present time, we have an adjunct who can
cover my fall MLT 101 course.
Need feedback about your idea(s)? Questions about your proposal? Questions about
this form? Contact a SLAT member:
Deborah Brock (dbrock5@tctc.edu or 864.646.1351)
Glenn Hellenga (ghelleng@tctc.edu or 864.646.1585)
Croslena Johnson (cjohnso5@tctc.edu or 864.646.1568)
Amoena Norcross (anorcros@tctc.edu or 864.646.1365)
Kate Williams (kwilli23@tctc.edu or 864.646.1607)
09.18.2014
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