Community Partner Information Form

Information you submit in this form will be used to update our contact list of community organizations, refer faculty interested in teaching service-learning courses to relevant community organizations, and advertise volunteer opportunities to students. If you have any questions, please contact Lesley Graybeal, Director of Experiential and Community-Engaged Learning, at lgraybeal@uca.edu or 501-852-7416. Thank you, and we look forward to supporting your work in our community!

Organization Information
Organization*
Website*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Name*
First Last
Position Title
Phone*
Email*
Organization Details
Is your organization a nonprofit or government agency?*
Type of Service Provided*
Are you interested in having UCA service-learning courses or student volunteers/interns work with your organization?*
- Interns
- Ongoing Volunteers
- Service-Learning Course
- Volunteers for Specific Events
Current Opportunities*
Please provide information about current opportunities for UCA students to get involved with your organization, including what, when, where, and how many students are needed.
Future Project Ideas*
Please share any ideas you have for how students in particular disciplines could use their skills to assist your organization or the people you serve (including direct service or indirect, behind-the-scenes projects).
What departments/faculty/students do you think could best serve your organization?*
Does your organization have specific guidelines or training for volunteers?*
Are background checks required to work with your organization?*
If background checks are required, by whom is the cost covered?
Are you interested in having UCA students host their own fundraisers or donation drives for your organization?
Please provide information about what types of donations your organization accepts (if applicable).
Has your organization worked with UCA faculty or students before? If so, briefly describe previous partnerships/projects and provide any feedback you would like to share.*
Would you like to be added to the monthly Community Partner Newsletter?*
Would you like to schedule a follow-up phone call with the Director of Experiential and Community-Engaged Learning?*
Would you like to schedule a time for the Director of Experiential and Community-Engaged Learning to visit your organization?*

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Adult Education/Mentoring
Advocacy/Politics
Animal Welfare
Arts/Culture
Children/Youth Education/Mentoring
Crisis Support
Disaster Relief/Emergencies
Environment
Food Insecurity/Hunger Relief
Health/Medical
Housing/Homelessness
Immigrants/Refugees
International
LGBTQ+
Military/Veterans
People with Disabilities
Race/Ethnicity
Seniors/Elder Care
Sports/Recreation
Substance Abuse Prevention
Women/Girls
Other (Not Listed)

Community Partner Information Form

Community Partner Information Form

Organization Information

Organization Details