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Student Evaluation Form
Semester of Service
Year
First, we would like some information about you.
What is your age group?
What is your ethnic background?
What is your gender?
What is your current student status?

Name of agency with which you worked during this class.
I have a job that requires me to work:
SERVICE-LEARNING
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Next we would like to gain your perspective about this course. Please mark your level of agreement with each statement. (Strongly Disagree, Disagree, Neutral, Agree,
Strongly Agree)
a. The community service aspect of this course helped me to see how the subject matter I learned can be used in everyday life.
b. The community service I did helped me to better understand the lectures and readings in this course.
c. The idea of combining work in the community with college course work should be practiced in more courses at this college.
The next set of questions relates to your attitude toward community involvement. Please indicate your level of agreement with each statement. (Strongly Disagree, Disagree, Neutral, Agree, Strongly Agree)
a. I was already volunteering in the community before taking this course.

b. I feel that the community service I did through this course benefited the community.
c. I was able to work directly with a community partner.
d. I felt a personal responsiblity to meet the needs of the community partner.
e. I probably won't volunteer or participate in the community after this course.
f. My interactions with the community partner enhanced my learning in this course.
Please rate your experience with the organization at which you participated. (Very Dissatisfied, Dissatisfied, Satisfied, Very Satisfied, Not Applicable)
a. Helpfulness of agency staff.
b. Adequate orientation/training.
c. Adequate supervison.
d. Meaningful tasks to perform.
e. Acceptance and support.
f. Recognition for my efforts.
Please rate the services provided by the staff at the Service-Learning Center.(Very Dissatisfied, Dissatisfied, Satisfied, Very Satisfied, Not Applicable)
a. Helpfulness of office staff.
b. Service documentation.
c. Adequate orientation.
d. Application process.
e. Cooperation, friendliness of staff.
f. Quality of communication with office.
g. The amount of agency information provided.
Did you receive enough help, support and guidance from:
The Service-Learning Staff

The Instructor

The Agency
Comments:
The following questions concern the reflection activities in the course. Please mark your level of agreement with each statement. (Strongly Disagree, Disagree, Neutral, Agree, Strongly Agree)


a. I think the reflection activities in this class allowed me to explore and clarify my personal values.
b. I think the reflection activities in this class allowed me to explore and clarify my commitment to the community..
c. I think the reflection activities in this class allowed me to explore and clarify my course content.
Please discuss to what extent the reflection activities were a regular part of the course.
Please discuss to what extent the reflection activities were structured with clear directions and guidelines.

Please mark your level of agreement with the following statement:
My Service-Learning experience had at least a moderate effect on the following: (Strongly Disagree, Disagree, Neutral, Agree, Strongly Agree)
a. Future course selection
b. Improved GPA?
c. Positive attitude toward academic studies/other classes.
d. Better relationships with faculty members?
e. Desire to stay in college or complete degree?
f. Acquisition of specific academic skills and knowledge?
g. Positive attitude toward "experiential" programs like this one?
i. Positive attitude toward Central Piedmont Community College?
j. Improved self-confidence?
k. Ability to learn and work independently?
l. Insight into your personal strengths and weaknesses?
m. Sense of personal achievement?
n. Sense of social responsibility or commitment to public/human service?
h. Positive attitude toward community involvement/citizenship?
Finally, what has your Service-Learning experience meant to you?
p. Development of functional life skills, e.g. communication, assertiveness, problem solving?
u. Knowledge of your community?
q. Development of occupational skills?
r. Understanding of social/cultural differences?
o. Ethical/moral development?
s. Application of classroom knowledge?
Thank You For Making A Difference!