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Worcester State University

Center for Service Learning & Civic Engagement

Project Name *

Faculty *

Department *

Students *

Students or SL course name

Semester *

Paid or Unpaid Internship

Community Partner #1 *

#1, number of students *

#1, hours per student *

#1, Total Student hours *

Do you have another? *

Yes

No

Do you have another community partner?

Community Partner #2

#2, number of students

#2, hours per student

#2, Total Student hours

Community partner #3

#3, number of students

#3, hours per student

#3, Total student hours

Placement Type *

Placement Setting *

Brief project description

Attachments

© WSU, 486 Chandler Street, Worcester, MA 01602
Phone: 508-929-8000