Experiential Learning Approval Request

Students submit this form to request approval for Experiential Learning.

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This field is for validation purposes and should be left unchanged.

Student Information

Name(Required)

First Last

Student ID Number(Required)

Email(Required)

Phone(Required)

Academics

Academic Department(Required)

Academic Advisor(Required)

Academic Advisor's Email(Required)

Enter Email Confirm Email

Please verify that this is correct; a summary of this request will be emailed to the address you provide.

Supervisor

Supervisor's Name(Required)

Supervisor's Email(Required)

Enter Email Confirm Email

Please verify that this is correct; a summary of this request will be emailed to the address you provide.

Select your SLOs

First SLO(Required)

Personal Growth & Lifelong Learning -- Demonstrate the personal impact of experiential learning experiences through reflection

Second SLO(Required)

Select at least one of the remaining four SLOs

Analysis & Communication: Analyze complex information in order to generate and communicate new knowledge

Practical Application & Skills Development: Apply acquired knowledge and practical skills

Creativity & Expression: Produce original creative work and/or perform, interpret, or curate work

Ethical & Civic Engagement: Explore civic engagement by actively participating in community-centered and/or globally-engaged experiences

About Your Experiential Learning

Location(Required)

Where will your Experiential Learning take place?

Start Date(Required)

When will your Experiential Learning begin?

End Date(Required)

When will your Experiential Learning end?

Description(Required)

Provide a brief description of your activity, and/or upload a prepared proposal document in the next section

Upload Documents

You may use this field to upload relevant documents (optional)

Drop files here or

Max. file size: 256 MB.