Fall 2021 Service-Learning Form 2

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This form is a confirmation of Hours Served and Reflection Completed. Students: please send this form to both your community service agency supervisor and your professor. This form is required for ALL students participating in service-learning this semester.

Please submit this form by Thursday, December 10, 2021.

If you have any questions, please feel free to reach out to the Office of Service-Learning at servicelearning@northshore.edu. We can provide alternative versions of this form (PDF or Word) upon request.

Email *

Please indicate your connection with the student. *

I am the student's community service agency supervisor.

I am the student's professor at North Shore Community College.

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