Civic Engagement Designation Proposal Form Question Title * 1. Name Question Title * 2. Email address Question Title * 3. Department Question Title * 4. Does this course meet any additional Learning Outcomes (LOs) as part of the Connections Curriculum? No Yes, it fulfills LO... Question Title * 5. I would like to designate... this section of the course only. This is the best option if another faculty member sometimes teaches this course or if you are trying a new experience. the course permanently. This is the best option if the course always requires civic engagement and/or you're the only one who teaches it. Question Title * 6. What is the department, number, and title of the course? Question Title * 7. Community Partner (name, organization, contact information)By providing this information you are verifying that you have had conversations with this partner. Question Title * 8. Please upload your syllabus here. Make sure that your syllabus includes the civic engagement statement and clearly explains how civic engagement is part of the course. PDF, DOC, DOCX file types only. Choose File Choose File No file chosen Remove File Please upload your syllabus here. Make sure that your syllabus includes the civic engagement statement and clearly explains how civic engagement is part of the course. Question Title * 9. If your course includes any kind of reflection assignments (e.g. journals, fieldnotes, structured conversations, etc.), please upload those here. PDF, DOC, DOCX file types only. Choose File Choose File No file chosen Remove File If your course includes any kind of reflection assignments (e.g. journals, fieldnotes, structured conversations, etc.), please upload those here. Question Title * 10. Describe the civic engagement opportunity. We recognize that projects and community partnerships may not be fully determined until closer to the start day of the course. Using your best projections at this time, please discuss how you anticipate students will meet the minimum hour component (12.5 hours) through course activities related to civic engagement. Question Title * 11. How will your course and civic engagement experience help students meet these outcomes? 1. Students will make connections between new knowledge and community experiences2. Students will understand civic identity and commitment3. Students will reflect on the value of diversity in communities Question Title * 12. What opportunities will students have to receive feedback toward the learning outcomes throughout the semester? Question Title * 13. How will students be introduced to and learn about the mission and work of the community partner? How will they realize the impact of their work on the community partner’s goals? Question Title * 14. We prefer that you commit to using the Hagen Center's reflection assignment and assessment rubric to evaluate the civic engagement component of the course. Are you willing to do this? Yes No Comment (please specify) Question Title * 15. Do you have any questions or comments for the Civic Engagement Committee? Done