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California Focus & Citizenship Washington Focus Service Learning pre-project approval

Please complete the form below to have your Service Learning Project pre-approved for California Focus and Washington Focus.

Helpful tips:

use the service learning project planning guide to plan your project before your submit your project for review
copy and paste the questions from the application into a word document to work on your proposal, then copy and paste your proposal into the application
include your county staff in the process-this will make it easier to obtain a letter of support when you are ready to submit your application
use only approved 4-H emblems and logos
include University of California -Agriculture and Natural Resources on all marketing materials
use budget template provided
test your project using the service learning project evaluation

Service learning combines community service with more formal educational programs in order to deepen the service experience through self-evaluation. http://www.nonprofithub.com/service-learning.htm

Service Learning Project Planning Guide

Budget Template

Approved 4-H and ANR Logos

Standards of Quality in Service Learning

Project Evaluation Tool :Use this tool to evaluate your project to make sure it has all the elements of a service-learning project. Decide which of the statements is true for each characteristic and put the corresponding number in the "points scored" column. Total your points with a goal of reaching between 26 and 32 points.

Questions? Contact Jenna Colburn at jcolburn@ucanr.edu or 530-752-4359.

✻ = Required

General Information

County:

4-H Group/Club/Unit Name: ✻

Project Name: ✻

My project is a ✻

California Focus Project Citizenship Washington Focus Project

Street address where the bulk of work in this project will take place:

City:

State: CA
Zip:

Group Members
**Please indicate whether each member is a youth (y) or adult (a)

4-H Youth Member

Youth Leader: ✻

Youth Leader Age: ✻

Youth Leader E-Mail ✻

Youth Leader Phone ✻

Youth Leader Mailing Address ✻

Youth Leader City, State, Zip Code ✻

Adult Coach/Mentor (4-H Volunteer or Staff)

Adult Coach ✻

Adult Coach E-mail: ✻

Adult Coach Phone: ✻

Adult Coach Mailing Address ✻

Adult Coach City, State, Zip Code ✻

Adult Coach's Role: ✻

Project Summary

Project Summary: Tell us about your project (100 words or less)
(This will be used for publicity & posted on the 4-H website.) ✻

Start Date:

✻

Expected End Date: ✻

What issue/problem in the community does this project address?
(1-2 paragraphs) ✻

Please describe your process of how you determined the community issue/problem.
(1-2 paragraphs) ✻

What community organization(s) will you collaborate with?
(We strongly suggest you provide a letter of support from your community partner(s) showing their support for your project.) ✻

Service

Who will this project serve (audience)? ✻

How many people will you serve?
(Please provide a specific number or a range; for example "50-100 youth") ✻

What are the goals of the project? ✻

Describe the project: How will you achieve your goals? ✻

Make a list of your tasks and include who will do what, where, and when. ✻

Outline the needed resources and how/where they will be obtained ✻

How will this project benefit the community or the organization(s) you are working with? ✻

Learning

What will the 4-H members learn?
(1-2 paragraphs; please describe specific learning goals.) ✻

Evaluation and Documentation of the Project

Describe how you will evaluate your project. How will you determine success?
(1-2 paragraphs) ✻

How will you capture the the impact the project had on the participants and on the community?
(1-2 paragraphs) ✻

Describe your plans for visibility and media outreach.
(1-2 paragraphs) ✻

Applicant Agreement

I confirm the accuracy of the information provided. I understand I must provide a “4-H Delivers” final report once the project is completed to receive pin and certificate of completion. ✻

Yes No

County 4-H Youth Development Staff Statement of Support

(Note: If you do not currently have a letter to attach, please email it within two weeks to Jenna Colburn at jcolburn@ucanr.edu.)

I have attached a signed statement of support from county 4-H Youth Development staff. ✻

Yes No

Upload Files:
1) Photograph or graphic that characterizes your project. (This will be used on the 4-H Website.)
2) Budget.
3) County 4-H Office Support Letter.
4) Community Organization Support Letter (optional).

Upload your file(s)

Survey Verification✻

For verification that you are human, please enter the following code in the box below:
NJXOBW

(if the code is not entered correctly, the survey will not be submitted)