SRVCLRNG 293: Learning Through Community Engagement Student Bridges Course Application Fall 2014 & Spring 2015 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 2013 & spring 2014 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 - 12:45 pm: Tutor-mentor middle school students at Peck Full Service Community School to support their academic preparation and success. (Holyoke) Team III: Mondays and Wednesdays, 2:30 pm - 6:30pm: Tutor-mentor middle school students at the CHOICES-STEP after school program. (Holyoke) Team IV: Tuesdays and Thursdays, 2:30 pm - 6:30 pm: Tutor-mentor middle school students at the CHOICES-STEP after school program. (Holyoke) Team V: College Access Workshops with High School Students (Springfield) Times and Days TBD Team VI: Monday/Wednesday 2:30 - 6:30 pm: Tutor-mentor middle school students and implement hands on Science, Engineering and Technology curriculum at the South End Community Center after school program. (Springfield) Team VII: Tuesday/ Thursday 2:30 - 6:30 pm: Tutor-mentor middle school students and implement hands on Science, Engineering and Technology curriculum at the New North Citizens’ Council after school program. (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 1 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: Do you speak a second language? If yes, which? 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? Call 413-545-7676 or visit www.studentbridges.org 2