SRVCLRNG 293: Learning Through Community Engagement
Student Bridges Course Application Fall 2015 & Spring 2016
By filling out this application, I am aware that this course requires:
● A full year commitment to the class is mandatory.
● Attendance at weekly class meetings (Tues. 7 - 9 pm at Wilder Hall) throughout Fall 2015 & Spring 2016
semesters.
● Completion of related course work (essays, readings and a final group project during the spring).
● Participation in Holyoke Bound &/or Springfield Bound (Saturdays, Dates TBD), Hip Hop Revolution
(1x/semester), and Tutor/Mentor Trainings (dates TBD).
● Twice a week Community Service through academic tutoring and mentoring for local youth in Holyoke or
Springfield.
1. Your Information:
Name:
Phone:
Email:
Major(s) & Minor(s):
Anticipated Graduate Date:
Spire #:
Race/Ethnicity:
2. Rank Your Preferred Community Service Learning Team:
**(These times/days are subject to change, we will update you should changes occur)**
Rank Your
1st, 2nd & 3rd
Choice
This course requires a two-semester commitment to one of the following teams.
 NOTE: The times listed signify departure and arrival times from the Student Union,
transportation to site is provided.
Team I: Mondays & Wednesdays 8:30 am - 1:15 pm: Tutor-mentor middle school students at Peck
Full Service Community School to support their academic preparation and success. (Holyoke)
Team II: Tuesdays & Thursdays, 8:30 am - 1:15 pm: Tutor-mentor middle school students at Peck
Full Service Community School to support their academic preparation and success. (Holyoke)
Team III: Mondays & Wednesdays, 2:30 pm - 6:30pm: Tutor-mentor middle school students at the
CHOICES-STEP after school program. (Holyoke)
Team IV: Tuesdays & Thursdays, 2:30 pm - 6:30 pm: Tutor-mentor middle school students at the
CHOICES-STEP after school program. (Holyoke)
Team V Mondays & Wednesdays 2:30 pm – 6:00 pm: Tutor-mentor High School students in the
Upward Bound Program at Commerce High School after school. (Springfield)
Other Volunteer opportunities: I am unable to do any of the above teams and/or attend the Tuesday
night class. However, I am interested in arranging an individualized volunteer opportunity through
Student Bridges.
Please fill out both sides, if you need more room feel free to attach paper to this application
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3. Please help us get an understanding of who you are: (use additional paper as needed)
Is there anything we should know about
your site preferences? Please explain,
especially if you only listed one or two
choices.
Please describe your Interest In
Student Bridges: Why are you
interested in participating in “Learning
through Community Engagement”? How
did you find out about Student Bridges
and the class?
Skills & Past Experience: Do you have
mentoring, teaching, or community
organizing experience? What academic
areas are you most comfortable with
(math, writing, history, etc)? Do you have
any other skills that you could use with
students we will be working with
(computer programming, graphic design,
dance, art, music, etc.)?
Outside Commitments: Is there
anything that may interfere with your
ability to take the Student Bridges
courses and to work with your partner
program/site for the full Fall 2013
semester or the continuation into Spring
2014?
Connections at UMass & in the Local
Communities:
When did you enroll at UMass/Amherst?
Please describe any organizations or
programs you have worked with at
UMass or in local communities.
Language Skills: What languages are
you comfortable speaking? Please list.
Please list two references:
Name:
Relationship to you:
Organization:
Phone:
 Enrollment in the course SRVC LRNG 293 (Fall) requires: Registration on SPIRE, Submission of this
application, and setting up an in-person or telephone interview. Once you have completed these required
steps you will be notified whether you have been accepted to the program. Enrollment must be completed
by the end of add/drop
 We will confirm that we have received your application within a week of submission.
Return this application to: studentbridges@gmail.com or
407-409 Student Union Building, 41 Campus Center Way, Amherst MA 01003
Questions? Email: studentbridges@gmail.com or visit www.studentbridges.org
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