Forms

COVID-19 ANNOUCEMENT

In response to the COVID-19 pandemic and our efforts to ensure your safety and the safety of your loved ones, we have moved our operations to a virtual/remote format until further notice.

Attention Students

Please contact your instructors for directions on how to fulfill your Service-Learning course requirements. For questions about the forms and documentation contact Tiffany O'Brien at: 

evcservicelearning@evc.edu

Tiffany.O'Brien@evc.edu

Goggle Voice 408-780-0321


EVC Service-Learning Forms

The Service-Learning forms listed below are required for all campus and community placement. 

Click on the links below to view and save the forms onto your computer. You will need to use Adobe Acrobat Reader to view these forms. Complete and sign the forms and email to Tiffany.O'brien@evc.edu

Forms may also be obtained from the SL&PS  Center in the Acacia building A4-224 2nd floor when campus reopens.

Check Deadlines with your instructor and SL&PS Center

How to Enroll in Service LearningInstructions on how to complete forms

Student Enrollment
Basic student information to enroll student into program and assist in placement
Waiver of Liability, Assumption of Risk & Indemnity Agreement

Waiver of claims against San Jose Evergreen Community College District

Service AgreementContract between student and community agency specifying volunteer responsibility and schedule

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

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

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

Student-Initiated Agency ApplicationFor placement at an agency not included on the EVC Center for Service-Learning & Public Service list of approved sites. To be completed with the Community Agency Application form.
Note: When printing forms from this website, print duplicate copies for your instructor, community supervisor, and yourself.

EVC Public Service Forms

The Public Service forms listed below are required for all campus and community placement. 

Click on the links below to view and print the forms in PDF format. Adobe Acrobat Reader is required to view these forms.   Complete and sign the forms and email to Tiffany.O'brien@evc.edu

Forms may also be obtained from the SL&PS  Center in the Acacia Building A4-224 2nd floor when campus reopens.

How to Enroll in Public Service

Instructions on how to complete forms

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

Student EnrollmentBasic student information to enroll student into program and assist in placement

Service AgreementContract between student and community agency specifying volunteer responsibility and schedule

Service LogTime sheet for students to track hours/days of volunteer service

Supervisor's EvaluationEvaluation of student volunteer's performance completed by community agency supervisor

Student EvaluationEvaluation on student volunteer's feedback on Public Service experience

Community Non-Profit Agency Application

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

​CONTACT Us

 

Tiffany O'Brien

Program Assistant

Tiffany.O'Brien@evc.edu

Goggle Voice 408-780-0321


Marjorie Clark

Program Coordinator

Marjorie.Clark@evc.edu


CENTER HOURS

Monday - Thursday

 9:00am - 2:00pm


LOCATION

Acacia  Building A4-222

2nd Floor

 

EVC Supporting Page
Evergreen Valley College
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