WALTERS STATE COMMUNITY CC OFFICE OF BEHAVIORAL AND SOCIAL S VOLUNTEER HOURS VERIFICATION AND FINAL STUDENT EVALUATION Student Volunteers: When you have completed your hours, take this form to the agency supervisor at your service learning site. Once your supervisor has verified your hours, make sure he she completes the rest ofthe form and mails it to the address below. Agency Supervisor: The stuclent’s grade is dependent upon the timely completion and submission of this form, Please complet Walters State Community College BehavioralSocial Sciences 500 South Davy Crockett Pkwy Morristown, TN S7BL}6899 wane: Anna —bhnson— Agency: (4/SCC Supervisor's Name: PMichelle_ | certify that the above named student volunteered at our agency for a total of _(o SF _ hhours this semester. 3470 Please grade the following: Not BoC DF Applicable Dependability Attendance VI? Cooperation Interpersonal Skills Work Ethic Concern for Needs of Community and Clients Client Response to Student NINN Agency Response to Student Overall Evaluation of PerformanceBased on your experier you your organization «willing to continue offering service opportunities next semester? working with the students from the Service-Learning program, are 12 interested in discussing further continuation of service-learning placements? not interested in continuing service-learning placements at this time? Describe the most significant task completed by the student while serving your agency. Anne oas wwe some teaching Lohole and amnall resp lessens She did _a Phyming Gat in He Hot lesson and the Ife cyele of the butter ly Please make any additional comments about your student vou program that might be helpful in the future Anne is a very Caring Persen te the students She really has made great Connections couith ~ the shidents She 1 Qusesame teaaher THANKS FOK YOUR PARTICIPATION!