Service-Learning Requirement

Documentation of Completed Service

Name: ____________________________ SED 3370 Section _______ Semester: _____ Year: _____

You are expected to arrange and complete 10 hours of service learning for this course during this semester. You may choose
from these actions: 1) 10 hrs. of service learning in the form of being an online tutor—preferably a student from a background
different from your own or 2) a combination of some hours of online tutoring and some hours of attending/participating in
approved events hosted by the Stephen F. Austin State University Office of Multicultural Affairs or other events online provided
by your professor. If neither of those options are possible, I will have videos you can view, but you will need to meet with me
via zoom to discuss this option. Please complete the table below to represent that you have completed 10 hours of personal
growth through service learning and/or OMA experiences before the end of the fall semester.

Type of Service/ Date/Time Contact Person (Name, Description of activities Total Hours
Activity Phone, email) of direct
interaction

Service-Learning Documentation
 Service-Learning Requirement
Documentation of Completed Service

Place of Service/ Date/Time Contact Person (Name, Description of activities Total Hours
Activity Phone, email)

By submitting this form to the D2L dropbox for your course—by the end of the course, you are verifying this document to be an accurate
representation of your participation in at-least 10 total hours. Any infringement of Academic Honesty related to this assignment may
result in a grade of “F” in this class. All 10 hours must be completed after the start date of your enrolled course. Based on your integrity,
you will be trusted to document your hours.

NOTE: If you are doing online/virtual tutoring, you will need to provide proof of the parent’s permission. (The parent can write a note and
sign it and either take a picture of it and send it to you or send you an email.)

Service-Learning Documentation