Service-Learning Student Form

___ On Campus

___ Off Campus





Instructor(s): M. Nemetz


Course: US History


Period(s) Participating: 5, 6


Project Name: Booksharing: WW2


Date Submitted:

School: Marshall High School


Department: Social Studies


Grade Level(s): 11


Anticipated # of students: 60


Goal: Read and Present your book


SECTION 2 Name and Address of school where you presented your book:







SECTION 3 Explanation of why you chose this school:








SECTION 4 Name of student to whom you read and presented your book:




SECTION 5 Name of Social Studies teacher of this student:




SECTION 6 Time and date of your reading and presentation:




SECTION 7 : Explanation of what took place during your reading/presentation. Was the student interested? Why or why not? What did you do to create interest?









SECTION 8 Reflection Prompts: What did you learn about teaching from this experience? How did this experience benefit you?











SECTION 9 Student benefits: How did this experience benefit the student you read to? (Written by student you read to 5 sentences)









SECTION 10 Final comments: Have the social studies teacher of the student you read to fill in this section, and explain how he/she felt the student you read to benefited (or not) from this experience.










SECTION 11 Teacher Comment(s) / Recommendations (filled in by Mr. Nemetz):








Submitted by: ____________________________________________ Date: _____________

Student Signature

Approved: ________________________________________________ Date: _____________

Social Studies teacher of student you read to

Student participant: ____________________________________________ Date: _____________

Student Signature whom you read to: ______________________________