Community Service Form and Policy

COMMUNITY SERVICE DOCUMENTATION FORM
Student Name:
Date(s)
Start
Time
End
Time
Description of Event (including location):
Sponsoring Organization:
Specific Role of Student in Event/Activity:
Student Reflection on Activity:
Student Signature
Date
***[SUPERVISOR INFORMATION]***
Printed Name of Event/Activity Supervisor
Phone Number and Email Address
(A student may not sign for another student)
Signature of Event/Activity Supervisor
Date
(A student may not sign for another student)
_______________________________________
Approved by (Office of Student Affairs)
Revised 1/2016
____________________
Date
# of
Hrs.
Policy on Mandatory Community Service
Today’s health care providers are practicing in complex patient- and relationship-centered professions. Future
pharmacists must practice cooperatively and be proficient as clinical professionals and experienced in providing
compassionate service to our profession and communities.
Members of the University of Saint Joseph School of Pharmacy community are expected to serve the community
at large in a professional capacity that enhances learning and provides benefit to the community and profession.
A maximum amount of annual community service hours has not been established, however, it is expected that
each Doctor of Pharmacy student establish community service relationships and document a minimum of twenty
(20) hours of service annually with a minimum of 60 hours prior to graduation. Students will gain proficiency in
establishing professional working relationships with a variety of local volunteer organization(s) under the
guidance of the Student Affairs Office. Student may find the details for completing this service in their E-portfolio
guidelines. A selection of sample community service activities follows below in Table 1. Please note: No student
is permitted to sign the community service documentation form for another student.
Table 1: Sample Community Service Activities
Volunteering in a local soup kitchen or homeless shelters
Participating in or organizing a team to walk/run in a charity event
Participating in a Habitat for Humanity event
Participating in Earth Day events
Participating in or organizing School of Pharmacy authorized health screening events
Participating in St. Patrick/St. Anthony’s Franciscan Center for Urban Ministry events
Participating in medical mission trips
Participating in public/private school “Career Days” with a faculty member
Participating in a migrant farm worker clinic
Volunteering as a Big Brother/Big Sister
Promoting the profession to the community during Pharmacy Week events
Visiting day care centers or schools during Poison Prevention Week events
Assisting with faculty-led public health advocacy activities
Participation in school or town-sponsored medication take-back events
Student Handbook