Community Service Evaluation Form

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Community Service Evaluation Form
This section to be completed by the Diversity Scholar
Student’s Name: ________________________________
Today’s Date: ________________
Fall 20____ Winter 20____ Spring 20____
Organization Name: _______________________ Location of Service: _____________________
Describe how your community service promoted diversity on campus or in the community:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Was your CS work related to your major? If yes, how? If no, what did you gain from this experience?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
In what ways have you shared your diversity through your community service?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Diversity Scholar Signature _____________________________________________________
This section to be completed by onsite Supervisor
Supervisor Name: _________________________________ Phone number: ______________________
Organization: _________________________________, Total volunteer hours completed: ___________
Describe the volunteer activities and their overall quality of work:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
What feedback can you provide to help the volunteer improve their skills as a volunteer?
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________
Supervisor Signature _____________________________________________________

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