Intent to use the Civic Action Scorecard in Your Course

Tell us if you are planning to assign civic actions from the Civic Action Scorecard in a course so that we can ensure you and your students SUCCESS through the provision of resources, training, and support catered to your needs!

This 2-minute survey will help us know who's planning to use the CAS so we may direct outreach and support your way!

NOTE: If you are a certified faculty verifier, but are NOT planning to assign the CAS as part of a course requirement for your course, you do NOT need to fill out the survey.

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Your Information

First Name *

Last Name *

Email Address *

Phone Number

Intent to Use the Civic Action Scorecard for a Course

Are you a certified CAS faculty verifier? *

i.e. completed the required 30-minute training and faculty verifier acknowledgement.

Course Number *

Course Title *

Course Registration Number(s) *

Please list the CRN(s) of your class.

Course Schedule and Location *

Please list days, times, and location of your class. (if online, is it synchronous or asynchronous).

Number of students who will be completing civic actions? *

Please describe what your civic action assignment will entail? *

(i.e. 50 points/student from any category, 20 points/student from a single category, 30 points/student from 2 categories, 1-2 specific civic actions/student, etc. Also tell us if civic actions will be required or optional).

Your Information

Intent to Use the Civic Action Scorecard for a Course

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