Honor Roll Application

President’s Higher Education Community Service

Honor Roll Application

Program Purpose: The President’s Higher Education Community Service Honor Roll program is designed to encourage and increase public awareness of community service by college students and to recognize and promote exemplary programs and effective practices in higher education community service. Presidential Awards are made for General Community Service and for service in the Special Focus area identified in this year’s Application Guidance.

Uses of information: Information provided in the “exemplary project” descriptions may be published in connection with the Honor Roll on the Corporation for National and Community Service (CNCS) website. All other information provided via this application will be cited publicly solely in aggregate, non-institutionally identifiable terms.

APPLICANT INFORMATION

Institution of Higher Education: ________________________________________________

(Official institutional name, as it would appear on the Honor Roll)

Name of chief executive officer: __________________________________________

Indicate President, Chancellor, or other title: ____________________

Official Institution Contact Information: Street Line 1: ______________________________

Street Line 2: ______________________________

City: _____________________________ State: __

ZIP: ______

Phone: _______________ Fax: ________________

Email address: _____________________________

Individual completing application: ________________________________________________

Department/ Office: ________________________________________________

Official Department Contact Information: Street Line 1: ______________________________

Street Line 2: ______________________________

City: ________________________ State: ___

ZIP: ______

Phone: ________________Fax: _______________

Email address: _____________________________

Institution’s 6-digit IPEDS code _______ and 8-digit OPEID number ____________ (Both are listed on COOL, at http://nces.ed.gov/ipeds/cool)

Total student enrollment (graduate and undergraduate, full and part-time): _____________

Institutional type (Check one):

Two-year public ______ Two-year private ______

Four-year public ______ Four-year private ______

Graduate students only, public ______ Graduate students only, private ______

Other (please describe) _________________________________________________

Minority-serving institution (Check as appropriate):

Historically Black College or University ______

Hispanic-Serving Institution _______

Tribally Controlled Institution _______

Is the applicant institution recognized under one of the Carnegie Foundation’s new Community Engagement classifications? _____ Check as appropriate:

Curricular Engagement ____

Outreach and Partnerships ____

Curricular Engagement and Outreach and Partnerships _____

How did the applicant institution learn about the Honor Roll program? (Indicate all that apply.)

Media advertisement _____

Media news story _____

CEO’s letter to higher education chief executives _____

Outreach (website, newsletter, etc.) by CNCS or its programs ____

Outreach by Campus Compact _____

Outreach by another higher education organization _____

Other ______

Definitions

Community service means: activities designed to improve the quality of life of off-campus community residents, particularly low-income individuals. Community service activities may include but are not limited to: academic service-learning , co-curricular service-learning (not part of an academic course, but utilizing service-learning elements) and other co-curricular student volunteer activities, as well as Work-Study community service and paid community service internships. Community service includes both direct service to citizens (e.g., serving food to the needy) and indirect service (e.g., assessing community nutrition needs or managing a food bank).

Academic service-learning means: service that is integrated with academic course content. It may involve direct or indirect service, and may include academic research.

CNCS programs include: AmeriCorps*VISTA, AmeriCorps*State and National, AmeriCorps*NCCC, Learn and Serve America, and Senior Corps.

****All estimates requested in this application are for the

12-month period ending June 30 of the Honor Roll year****

General Community Service: Student Service Estimates

1. Estimate the number of students who engaged in academic service-learning. __________

2. Estimate the number of students who engaged in forms of community service other than academic service-learning. __________

3. Estimate the total number of students who engaged in community service of any kind. (total of (a) and (b)) __________

4. Estimate the number of students who engaged in at least 20 hours of community service per semester. __________

5. Estimate the number of students whose service was supported by one or more CNCS programs. __________

6. Estimate the total number of service hours engaged in by the institution’s students. __________

General Community Service: Exemplary Project Descriptions

In the blocks below, please provide narrative descriptions of up to five especially successful student community service projects. Please title each project and limit each project description to 1,800 characters, approximately 300 words. (Every block need not be used. Include only exemplary projects.) Within each project description, provide details pertaining to each of the three evaluation categories: Scope, Innovation, and Evidence of Effectiveness. (See Application Guidance for definitions.)

Each project description MUST include:

1. Indication of the kinds of services provided;

2. Detailed evidence, including quantification if possible, of the project’s benefits to individuals and communities; and

3. Whether student participation was during regular academic sessions or during summer or other breaks.

If relevant, project descriptions should also discus:

1. Program practices or institutional support elements that were found particularly helpful or effective;

2. Collaborations with community agencies, including K-12 schools; and

3. Whether the project was supported by Federal Work-Study, CNCS programs, or other Government programs.

Project 1

Title: _________________________

Number of participating students ______ Number of student service hours ______

Number of participating faculty/ staff ______ Number of faculty/ staff service hours ______

Issue areas: Indicate each of the following issue areas that were addressed by this project

(a drop-down list)

At-risk Youth ___

Community and Economic Development___

Culture/Arts/ Performance___

Disaster/ Emergency Prevention and Mitigation ___

Disaster/ Emergency Response and Recovery ___

Education/ Dropout prevention___

Employment___

English as a Second Language___

Environment ___

Health/ Nutrition___

Homelessness___

Housing ___

Hunger___

Mentoring ___

Senior Citizen Services___

Special Needs Support for the Disabled ___

Tutoring ___

Youth Development ___

Other ___

Narrative block:_____________________________________________________________

__________________________________________________________________________

Project 2

Title: ________________________

Number of participating students ______ Number of student service hours ______

Number of participating faculty/ staff ______ Number of faculty/ staff service hours ______

Issue areas: Indicate each of the following issue areas that were addressed by this project

(a drop-down list, same as above)

Narrative block: ______________________________________________________________________

_______________________________________________________________________

Project 3

Title: ________________________

Number of participating students ______ Number of student service hours ______

Number of participating faculty/ staff ______ Number of faculty/ staff service hours ______

Issue areas: Indicate each of the following issue areas that were addressed by this project

(a drop-down list, same as above)

Narrative block: ______________________________________________________________________

_______________________________________________________________________

Project 4

Title: ______________________

Number of participating students ______ Number of student service hours ______

Number of participating faculty/ staff ______ Number of faculty/ staff service hours ______

Issue areas: Indicate each of the following issue areas that were addressed by this project

(a drop-down list, same as above)

Narrative block: ______________________________________________________________________

_______________________________________________________________________

Project 5

Title: ______________________

Number of participating students ______ Number of student service hours ______

Number of participating faculty/ staff ______ Number of faculty/ staff service hours ______

Issue areas: Indicate each of the following issue areas that were addressed by this project

(a drop-down list, same as above)

Narrative block: ______________________________________________________________________

_______________________________________________________________________

Special Focus Area: Student Service Estimates

(These estimates should be included in the General Community Service estimates above.)

1. Estimate the number of students who engaged in academic service-learning in the Special Focus Area – as identified in the Application Guidance __________

2. Estimate the number of students who engaged in forms of community service other than academic service-learning in the Special Focus Area. __________

3. Estimate the total number of students who engaged in community service of any kind related to the Special Focus Area (total of (a) and (b)) __________

4. Estimate the number of students who engaged in at least 20 hours of community service per semester in the Special Focus Area. __________

5. Estimate the number of students whose service in the Special Focus Area was supported by one or more CNCS program. __________

6. Estimate the total number of service hours in the Special Focus Area engaged in by the institution’s students. __________

Special Focus Area: Exemplary Project Descriptions

In the blocks below, please provide narrative descriptions of up to five especially successful student community service projects. (Every block need not be used. Include only exemplary projects.) Please title each project and limit each project description to 1,800 characters, approximately 300 words. Within each project narrative description, provide details pertaining to each of the three evaluation categories: Scope, Innovation, and Evidence of Effectiveness. (See Application Guidance for definitions.)

Each project description narrative MUST include:

1. Indication of services/ expertise provided;

2. Details, including quantification if possible, concerning the project’s benefits to individuals and communities; and

3. Whether student participation was during regular academic sessions or during summer or other academic breaks.

If relevant, project descriptions should also discus:

1. Program practices or institutional support elements that your institution found particularly helpful or effective;

2. Collaborations with community agencies, including K-12 schools; and

3. Whether the project was supported by Federal Work-Study, CNCS programs, or other Government programs.

Project 1

Title: _________________________

Number of participating students______ Number of student service hours ______

Number of participating faculty/ staff ______ Number of faculty/ staff service hours ______

Issue areas: Indicate each of the following issue areas that were addressed by this project

(a drop-down list)

At-risk Youth ___

Community and Economic Development___

Culture/Arts/ Performance___

Disaster/ Emergency Preparation and Mitigation ___

Disaster/ Emergency Response and Recovery ___

Education/ Dropout Prevention__

Employment___

English as a Second Language___

Environment___

Health/ Nutrition___

Homelessness___

Housing___

Hunger___

Mentoring___

Senior Citizen Services___

Special Needs Support for the Disabled___

Tutoring___

Youth Development___

Other ____

Narrative block:_____________________________________________________________

__________________________________________________________________________

Project 2

Title: ________________________

Number of participating students ______ Number of student service hours ______

Number of participating faculty/ staff ______ Number of faculty/ staff service hours ______

Issue areas: Indicate each of the following issue areas that were addressed by this project

(a drop-down list, same as above)

Narrative block: ______________________________________________________________________

_______________________________________________________________________

Project 3

Title: ________________________

Number of participating students ______ Number of student service hours ______

Number of participating faculty/ staff ______ Number of faculty/ staff service hours ______

Issue areas: Indicate each of the following issue areas that were addressed by this project

(a drop-down list, same as above)

Narrative block: ______________________________________________________________________

_______________________________________________________________________

Project 4

Title: ______________________

Number of participating students ______ Number of student service hours ______

Number of participating faculty/ staff ______ Number of faculty/ staff service hours ______

Issue areas: Indicate each of the following issue areas that were addressed by this project

(a drop-down list, same as above)

Narrative block: ______________________________________________________________________

_______________________________________________________________________

Project 5

Title: ______________________

Number of participating students ______ Number of student service hours ______

Number of participating faculty/ staff ______ Number of faculty/ staff service hours ______

Issue areas: Indicate each of the following issue areas that were addressed by this project

(a drop-down list, same as above)

Narrative block: ______________________________________________________________________

_______________________________________________________________________

Institutional Supports for Service

1. Is community service or service-learning explicitly cited in your institution’s mission statement or strategic plan?

Yes ________ No ________ Don’t know/ data not available ________

2. Does the applicant institution have at least one full-time staff member responsible for coordinating student community service or service-learning activities?

Yes ________ No ________ Don’t know/ data not available ________

If yes, how many? ________

3. Does the applicant institution provide scholarships or other financial rewards to students for community service, such as “matching” the Segal AmeriCorps Education Award?

Yes ________ No ________ Don’t know/ data not available ________

4. Does the applicant institution offer academic courses that integrate community service with academic content, i.e., academic service-learning courses, as defined above?

Yes ________ No ________ Don’t know/ data not available ________

If yes, approximately how many? __________

5. Does the applicant institution require academic service-learning courses as part of the core curriculum of at least one major or disciplinary area?

Yes ________ No ________ Don’t know/ data not available ________

6. Does the applicant institution reward the use of academic service-learning through faculty promotion and tenure decisions, or by providing awards or professional development opportunities?

Yes ________ No ________ Don’t know/ data not available ________

Government Supports for Service

1. Does the applicant institution utilize AmeriCorps, including VISTA, members in recruiting student volunteers or coordinating student service projects?

Yes ________ No ________ Don’t know/ data not available ________

2. Does the applicant institution have an ongoing grantee, sub-grantee or other supportive relationship with any of the following CNCS programs?

Learn and Serve America ______

Americorps*State and National ______

AmeriCorps*VISTA ______

AmeriCorps*NCCC ______

Senior Corps ______

Please identify any ongoing relationship the applicant institution has with other Federal, State, or local government agencies in support of student community service activities: ________________________________________________________________

________________________________________________________________

THANK YOU FOR TAKING THE TIME TO COMPLETE THIS APPLICATION.

WE APPRECIATE ALL THE WORK THAT YOU DO!

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