Forms

The forms listed below are required for Service-Learning and Public Service placement. Click on the links below to view and print the forms in PDF format. Adobe Acrobat Reader is required to view these forms.
Copies may also be obtained from the Service-Learning and Public Service Center in A4-224. Please check with your instructor or the Center for form deadlines.

How to Enroll for Service Learning– Step by Step Instructions
Detailed instructions on how to properly complete forms

Service-Learning Forms:

1.  Waiver of Liability, Assumption of Risk & Indemnity Agreement
Waiver of claims against San Jose Evergreen Community College District

2. ​Student Enrollment

Basic student information to enroll student into program and assist in placement

3. Service Agreement 

Contract between student and community agency specifying volunteer responsibility and schedule

4. Service Log

Time sheet for students to track hours/days of volunteer service

5. Supervisor's Evaluation

Evaluation of student volunteer's performance completed by community agency supervisor

6. Student Evaluation

Evaluation on student volunteer's feedback on Service-Learning experience

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How to Enroll for Public Service – Step by Step Instructions
Detailed instructions on how to properly complete forms

Public Service Forms:

1.  Waiver of Liability, Assumption of Risk & Indemnity Agreement
Waiver of claims against San Jose Evergreen Community College District

2. Student Enrollment

Basic student information to enroll student into program and assist in placement

3. Service Agreement 
Contract between student and community agency specifying volunteer responsibility and schedule

4. Service Log

Time sheet for students to track hours/days of volunteer service

5.  Supervisor's Evaluation

Evaluation of student volunteer's performance completed by community agency supervisor

6. Student Evaluation

Evaluation on student volunteer's feedback on Public Service experience

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Other Forms:

Student-Initiated Agency Application
For students who wish to complete his/her Service-Learning placement at an agency not included on the EVC Center for Service-Learning & Public Service list of approved sites. This form must be completed along with Community Agency Application (see form below).

Community Agency Application
For non-profit agencies wishing to establish a partnership with the Center for Service-Learning & Public Service

Short-Term Service Log
Time sheet to track hours/days on on-day volunteer opportunities at multiple locations

Publicity & Photo Release
Contract granting permission to use student's name, likeness, image, voice, and/or appearance on behalf of EVC Center for Service-Learning & Public Service

Note: When printing forms from this website, it is your responsibility to print duplicate copies for your instructor, community supervisor, and yourself.

​CONTACT Us

Location: A4-224
(Acacia bldg, 2nd Floor)

408.223.6770
evcservicelearning@evc.edu 

Center Hours

Mon-Thurs: 9:00am - 1:00pm

Fri:  Closed

Summer:  Closed

STAFF:

Marjorie Clark, Program Coordinator
E: Marjorie.Clark@evc.edu​​

Tiffany O'Brien, Program Assistant
E: Tiffany.O'Brien@evc.edu

EVC Supporting Page
Evergreen Valley College
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