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University of Utah COVID-19 Updates
The University of Utah
Bennion Center
For Community Engagement
Students
CEL FACULTY
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Current Page:
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
Briefly describe this course
Briefly describe how a CELA will help you facilitate a consistent community-engaged learning experience for students enrolled in the course.
Please list the specific community partners your class will be working with (if known)
I would like assistance identifying partners.
Yes
No
Have you identified a student to serve as your CELA?
Yes
Not Yet
I would like the Bennion Center to provide a trained LA.
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: 11/9/22