Service Learning Student and Agency Contract


Contact Information

  Student Name: _______________________________________________________________

  Student Phone/Email: _________________________________________________________


  Organization Name:___________________________________________________________

  Organization Address (include zip code)__________________________________________


  Site Supervisor Name: _________________________________________________________

  Site Supervisor Phone/Email: ___________________________________________________


General Purpose of the Project

-      To Participate in and observe Jewish organizational life.

-      To identify Jewish values (especially tikkum olam) that define and guide the mission and operation of the organization.

-      To critically observe the culture (behaviors, activities, debates, and struggles) of the organization and to link them to the process of defining contemporary Jewish values and identities.


Student Responsibilities and Learning Goals (this must be filled out BEFORE site supervisor signs this contract)


Hours per week:_______________________________________________________________

Start Date/End Date: ___________________________________________________________




Learning Goals:

  1. _______________________________________________________________________
  2. _______________________________________________________________________
  3. _______________________________________________________________________


Please read carefully and sign below:


We, the undersigned, agree to the following:

-      Student will attend an orientation to the host site

-      Student will work the required number of hours, make up for any absences, and communicate absences and vacations as soon as possible to the site supervisor

-      Student will abide by rules and regulations or the organization

-      Student will reflect on experience through journals and class discussion and will complete a final reflection paper on the experience.

-      Site supervisor will provide an orientation at the host site and will be clear about expectations

-      Site supervisor will provide feedback as appropriate and will evaluate students at the end of the semester

-      Both student and site supervisor will communicate problems or concerns to Professor Lester, 785.864.2503


_____________________________              _____________________________   

            (student)                                                     (site supervisor)  


Students will return Agreement to Professor Lester, and photocopies of the signed agreement will be distributed to student, site supervisor, Coordinator, and Course Instructor.  Thank you.