Iowa Wesleyan College

Today's Date:

Advisor:

First Name:

Middle Name:

Last Name:

Name of agency or institution:

Name of Site Supervisor - Last, First, (Mr., Ms., Dr.):

Site Supervisor's E-mail:

Site Supervisor's Phone Number:

Position:

Project Start Date:

Anticipated End Date:

Project Hours Anticipated:

ESSAY: In 250 words, please write a brief essay regarding your SL project stating your goals, objectives and how you plan on correlating the 4 Life Skills (Communication, Problem Solving, Valuing, and Effectiveness in Social Interaction) to your SL experience. The prospectus is worth 10 percent of your final service-learning grade. Please be sure to check for spelling and grammatical errors before submitting! In addition, you must correlate the 4 Life Skills to your project.:

Phone:

Address:

(City)

(State/Country)

(Zip)

Projected Graduation Month/Year:

Will this be your only SL Project?

Agency, institution, or situation in which you propose to complete your SL project:
(NOTE: You cannot complete your SL and Field Experience at the same location.)

(Street)