Submit A Service-Learning Lesson Plan

Do you have a service-learning lesson plan you want to share?
Please fill out the lesson plan submission form below and we will review for possible inclusion on this site. If you have any questions before filling out this form, please email GO@ysa.org.

Title of Your Service-Learning Experience ^(required)
Please enter the title of your service-learning experience or project. This is how visitors to the website will identify your lesson plan.

The Purpose and Essential Questions ^(required)
What was the primary purpose of this lesson for you as a teacher? For the students? For the community? If you developed essential questions, please include them here. Please limit your response to no more than 200 words.

The Story ^(required)
Tell us your story as it pertains to this service-learning experience – how you began, a summary of what occurred, and how the community responded. Please try to limit your response to no more than 200 words.

Service-Learning Theme(s) and Community Need

Service-Learning Themes ^(required)
Please select ALL the themes that apply to your service-learning experience.

AIDS Awareness & Education	Animals	Elders
Emergency Readiness	Environment	Gardening
Healthy Choices	Immigration	Literacy & Mentoring
Hunger, Homelessness, and Poverty	Safe and Strong Communities	Social Change
Special Needs and Disabilities

Community Need ^(required)
What community need did this service-learning experience address? Please try to limit your response to no more than 200 words.

Community Partners ^(required)
Who in the community (individuals, businesses, government offices, and/or organizations) participated? Please limit your response to no more than 200 words.

Place of Impact ^(required)
What place or kind of community benefited from your service-learning experience? Please select all that apply.

	School		Local Community		National
	Global		Virtual

School Setting, Grade Level and Duration

School Setting ^(required)

Suburban

Rural

Urban

Grade Level ^(required)

	K-3 (Early Elementary)		4-6 (Upper Elementary)		6-8 (Middle School)
	9-12 (High School)

Target Population ^(required)

All Students

Youth with Special Needs

Youth at Risk of Dropping Out

Duration ^(required)

	1-4 weeks		5-9 weeks		More than 9 weeks
	Semester of Service

Connection to Curriculum

Academic Subjects ^(required)
Please select all academic subjects that apply.

Agriculture	Art	Business
Career Exploration	Engineering	English Language Arts
Family and Consumer Sciences	Foreign Languages	Health Sciences
Life Skills	Math	Music
Physical Education	Science	Social Studies
Speech and Communication	Technology	Theater

State Standards ^(required)

State Standards being met - we require at least one (1) standard and recommend that 3 - 5 be filled out across multiple areas:

State: example: Connecticut
Subject: example: Health
Definition:

State:
Subject:
Definition:

State:
Subject:
Definition:

+ ADD ANOTHER STANDARD

Content Areas of major themes of study ^(optional)

Skills being introduced or developed ^(optional)

Books, Media, Websites, and other Resources ^(required)
Please list all resources that you and your students used during your service-learning experience.

Career-Related Learning ^(required)
Please list careers or career related experiences your students explored.

Five Stages of Service-Learning (Procedure)
(Investigation, Preparation and Planning, Action, Reflection, and Demonstration)
Please articulate what occurred in each stage as a step-by-step sequence. Include how reflection was integral within each stage in addition to its all-encompassing role as “Reflection,” stage four of the five.

Investigation: ^(required)

Reflection ^(optional)

Preparation and Planning: ^(required)

Reflection ^(optional)

Action: ^(required)

Reflection ^(optional)

Reflection: ^(required)

Demonstration: ^(required)

Reflection ^(optional)

Public Relations ^(optional)
Media attention, participation by, or information provided to elected officials, and other forms of presentation.

Assessment and Evaluation ^(required)
How did you assess student learning and the service outcomes achieved? What role did students have in the progress monitoring, assessment, and evaluation process? What role did community partners have in the assessment and evaluation process?

Lessons Learned and Next Steps ^(required)
What did you discover about service-learning through this experience? What would you do differently? How will you advance your service-learning practice? Any advice for other teachers?

About the Teacher ^(required)
Tell us about yourself. How long have you been teaching? How long have you been utilizing service-learning practices? What has been influential or helpful in becoming a service-learning practitioner? Please limit your response to 200 words or less. Please also upload a photo of yourself.

About the School ^(required)
Tell us about your school. Please limit your response to 200 words or less.

Your Information

Your Name	^(required)
Your School	^(required)
School City	^(required)
School State	^(required)
Your Phone	^(required)
Your Email	^(required)
Note: We ask for your phone number(s) and email address only as a way to reach you about the information you have submitted. We will in no way distribute or publish this information.

Acceptance of Use Agreement

By submitting this form, I agree to share all information and documentation with GoToServiceLearning, Youth Service America (YSA), and their partners. I also give permission for GoToServiceLearning, et al, to use all media (pictures, videos, etc..) that I send to accompany this service-learning experience.

I agree ^(required)

NOTE: You cannot upload pictures, videos, or supplementary materials directly to the website at this time. However, if you have JPEG pictures no larger than 1000x1000 pixels, a link to a video, Word documents, or PDFs, please send them to GO@ysa.org with the title of your service-learning experience in the subject line.