Community Outreach

 

Weekly Program Service Agreement and New Participant Information Form

Thank you for your interest in the Office of Community Outreach's

Weekly Programs!

Please read this information and complete the form below prior to your first visit to a Weekly Program this year.  You only need to complete this form one time each academic year even if you participate in multiple Weekly Programs.

Service Agreement

As a participant in an Office of Community Outreach Weekly Service Program, I agree to the following guidelines that will contribute to my effective service and successful experience as a participant.

  • I will dress in attire that is appropriate for the activities in which I will participate and the people with whom I will spend my time.
  • I will use language that is respectful and appropriate for the environment and which is suitable for a person representing Baldwin Wallace University.
  • I will act respectfully towards the Program Coordinator(s), site supervisor and community members with whom I will interact as a participant in this program and will treat all individuals with courtesy, dignity, and consideration.
  • I will maintain a level of confidentiality by keeping information about community members private when appropriate.
  • I understand that the Office of Community Outreach is not solely responsible for the success of my service experience and that my actions and attitudes will contribute significantly to my overall experience in this program(s).
  • I understand that these actions will not absolutely ensure my safety, the safety of my belongings, or the total success of my service; however, they will contribute to my overall experience as a service participant.

If I am unable to uphold any portion of this agreement, I understand that I may be asked to leave the program(s) at any point in time.  Further, I understand that I may speak with the Program Coordinator(s) who leads this program or contact the Office of Community Outreach at (440) 826-2403 for more information or clarification about this agreement.

* Required information
I have read the above guidelines and agree to adhere to them during my participation in all Office of Community Outreach sponsored activities
First Name: *
Last Name: *
Email Address: *
Building and Room # if you live on campus or complete address if you commute.: *
Gender:
Age:  17-19    20-22    23-25    26-30    30 and above  
Academic Status:  Freshman    Sophomore    Junior    Senior    Senior+    Faculty/Staff Member  
How did you hear about this program? Please check all that apply.:  Flyer    Word-of-Mouth    Campus or personal email    Blackboard    OCO Expo    Other  
Which Weekly Program(s) are you thinking of participating in at this time?  Big Brothers Big Sisters    Boys and Girls Club    CCBDD Wed.    CCBDD Thurs.    Esperanza    Food Center at Near West (St. Pat's)    Jennings Center for Older Adults    West Side Catholic Center  
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