Submit Activity FormHome / Submit Activity Form Are you Engaged with the Community? Tell us how! Visit the CE Register to submit your Community Engagement related activities at Mason: CE Register COMMUNITY ACTIVITY FORM: InstructionsGeorge Mason University is compiling information about short and long-term campus/community engagement activities in order to demonstrate the depth and breadth of our many partnerships. We invite any campus entity (faculty, staff, student organizations) who partners in a meaningful way with off-campus constituents (public, private, not for profit) to document your partnership using the form below. Examples of partnerships may include: involving off-campus collaborators in course design or delivery; community service and volunteer activities; community-based research and engaged scholarship; social enterprise and innovation projects; and more. We appreciate you taking time for this as we work to augment the levels of quality, meaningful outcomes, and transformation potential of Mason-community partnerships. Please email: engage@gmu.edu with any questions or concerns regarding this form.COMMUNITY ENGAGEMENT ACTIVITY:Name of Contact Person:* Contact Phone #:*Contact Email:* Project/Partnership Name:* Partnership Type:*Select all that applyArtsChild DevelopmentEconomic DevelopmentEducationEnviornmentGlobal ImpactHealthHunger/HomelessnessLocal Disaster ReliefLocal VeteransSenior CitizensSustainabilityOtherPartnership Type:*If other, please specify Length of Partnership:*In Years. Write N/A if unknownTotal Hours:*Number of participants x hours Region:*GlobalNationalOnlineDMV Metropolitan AreaNOVA WideVirginia WideAlexandriaArlingtonFairfaxFront RoyalLoudonPrince WilliamOtherRegion:*If Other, please specify: Mason Unit:*Select all that applyAdministrativeFacilitiesIntercollegiate AthleticsUniversity LifeCollege of Education and Human DevelopmentCollege of Health and Human ServicesCollege of Humanities and Social SciencesCollege of ScienceCollege of Visual and Performing ArtsHonors CollegeKrasnow Institue for Advanced StudyNew Century CollegeSchool for Conflict Analysis and ResolutionSchool of LawSchool of BusinessSchool of Policy, Government, and International AffairsVolgenau School of EngineeringOtherMason Unit:*If Other, please specify: Office/Department:* Funding Source:*Select all that applyGrantInternalExternalStatePrivate DonorFeeFreeOtherFunding Source:*If Other, please specify: Start Date:* MM slash DD slash YYYY End Date:Leave blank if project is still ongoing MM slash DD slash YYYY Budget Total:*Dollar Amount Project/Partnership Website:Leave blank if unknown or not applicable Number of Internal Faculty/Staff:Leave blank if unknown or project is still ongoingNumber of External Faculty/Staff:Off-campus faculty collaborators; Leave blank if unknown or project is still ongoingNumber of Internal Students:Leave blank if unknown or project is still ongoingNumber of External Students:Off-campus student collaborators; Leave blank if unknown or project is still ongoingProject Description:*Summary of Impact/Outcomes:*Benefit to Mason:*Benefit to Community:*Is this project/partnership Service Learning (Credit Bearing or Non-Credit Bearing)?*NoYesInstructionsThe remaining fields in this form are to capture data on Service Learning projects. SERVICE LEARNING (Credit & Non-Credit Bearing):Course/Program Name:* Course/Program Description:Leave blank if same as above Course/Program Number:*Write NA if not applicable Instructor/Coordinator Name:*Write NA if not applicable Semester Offered:*FallSpringSummerWinter IntersessionNot ApplicableNumber of Credits:*Write NA if not applicable Total Hours:* Captcha
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