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Community Engaged Learning - Assistant Application
Community Engaged Learning Assistant Application
Contact Information
Semester applying for
Fall
Spring
Summer
Instructor First Name
Instructor Last Name
Instructor Title
College
Please select...
Architecture + Planning
Business
Cultural and Social Transformation
Dentistry
Education
Fine Arts
Health
Honors College
Humanities
Law
Medicine
Mines & Earth Sciences
Nursing
Pharmacy
Science
Social & Behavioral Science
Social Work
Other
If other, please specify
Department or Program
Instructor Email
Phone
(e.g. xxx-xxx-xxxx)
Course Information
Course Name
Course Number and Section
(e.g. COMM 3660-001)
Anticipated Enrollment
Is this an existing CEL-designated course?
Yes
No
Was this course newly designated as CEL within the last year?
Yes
No
Unsure
Briefly describe this course
Briefly describe the work the CELA will conduct for this course
Please describe any special considerations related to the need for a CELA such as the complexity of the community engaged work or the workload of the instructor
Have you identified a student to serve as your CELA?
Yes
Not Yet
I would like CEL staff to assist with identifying a CELA
Student First Name
Student Last Name
Year in School
Please select...
Freshman
Sophomore
Junior
Senior
Graduate Student
Student uNID
Student Email
Please provide a chartfield for the stipend transfer
(a 1001 fund is preferred; if you do not know the Chartfield, please contact your department's accountant or administrative assistant. We strongly encourage departments to establish a CEL-specific account.)
Administrative Assistant Contact Information
First Name
Last Name
Email
Phone
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Last Updated: 2/24/25
