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EXL Agreement for External Activity
Experiential Learning
鶹Ƶ
Box 247
Murfreesboro, Tennessee 37132
Phone: (615) 898-5542
www.mtsu.edu/experience
Name: MTSU ID:
Major: E-mail:
Expected Graduation Date:
Academic Classification: ( FR ( SO ( JR ( SR
Semester/Year of Experiential Learning Experience:
Type of Activity: ( Research ( Service-Learning ( Team Competition
Summary of External Activity (include organization name): ___________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
External Supervisor Name: ____________________________________External Supervisor Phone: __________________
LEARNING OBJECTIVES:
List three learning expectations for this activity along with a short statement about each. These learning expectations will be used to evaluate your EXL experience.
Learning Expectation 1:
Learning Expectation 2:
Learning Expectation 3:
RESPONSIBILITIES UNDER THIS AGREEMENT
When signing the Learning Agreement each signer agrees to assume the responsibilities listed for his/her specific role:
The Service Learning/Team Competition student agrees to:
Work the minimum of hours required to receive EXL credit for the external experience (external service learning requirement is 24 hours in one semester and team competition is 24 hours in one or two semesters).
Act in a professional manner, maintain confidentialities, be open to constructive criticism through the experience, and comply with the rules, policies, and regulations of the employer;
Maintain a daily journal for the external activity and turn in by the designated due date.
For external service learning activities, the Supervisor agrees to:
Provide the student and the EXL Coordinator with a complete, accurate description of the duties and responsibilities associated with the EXL external activity prior to beginning the activity;
Supply an evaluation of the students performance at the end of the student's activity
Inform the EXL Coordinator of the students failure to make him/herself available to offered experiences or failure to respect the policies of the expected activity.
For undergraduate research and team competition activities, the faculty advisor agrees to:
% M o n i t o r s t u d e n t s w o r k
% P r o v i d e a n e v a l u a t i o n o f t h e s t u d e n t s p e r f o r m a n c e a t t h e e n d o f t h e a c t i v i t y
% I n f o r m t h e E X L C o o r d i n a t o r o f t h e s t u d e n t s f a i l u r e t o b e i n v o l v e d i n a c t i v i t i e s a s a g r e e d
T h e E X L C o o r d i n a t o r a g r e e s t o :
" M a i n t a i n c o m m u n i c a t i o n with the student and the external organization to assure maximum learning on the part of the student and satisfaction on the part of the organizations;
Assist student and external supervisor in resolving and problems or difficulties which may arise;
Help students and faculty in writing agreements which specify measurable Learning Objectives when
appropriate;
Evaluate the students placement and assess the organizations satisfaction with the learning experience.
Your signature below indicates that you have read and are in agreement to all pages of this document. This
agreement may be terminated by the student or the employing organization upon receipt of two weeks notice by
either party. This form should be submitted with the first two signatures.
Student: ________________________________________
Print Name Student Signature
External Supervisor: __________ __
(or faculty supervisor) Print Name Supervisor Signature
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Print Name EXL Signature
Date: ____________________________
PAGE
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proof:pdf
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2016-05-23T08:03:08-05:00
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2016-06-03T08:10:20-05:00
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