CES Reflection Outline Form – Center for Civic Engagement

Civic Engagement Scholars, please submit a complete structured reflection outline and event plan through this form for each reflection event you run.

Reflection Outlines Form

CESs will submit outlines for each reflection they lead. When a reflection is a collaboration between two or more programs, only one submission is needed and all associated programs should be listed in the notes.

Why we do structured reflection:

“We do not learn from our experiences, we learn from reflecting on our experiences.” -John Dewey We reflect so that we can better do our work. We reflect to better understand the systems and structures that shape our world, the impacts they have on communities, and our roles that we play. We reflect to learn from our experiences; to better understand ourselves and each other and to grow as people. We reflect to build trust and strengthen relationships within our group. We reflect to learn from one another and to provide systems of support and encouragement. We reflect to renew our energy and commitment to the work; to encourage deeper critical thought and inspire us to continue to grow in our work.

Civic Engagement Scholar Name and Program(Required)

Please list all CESs and programs involved in this reflection.

Reflection Logistics

Reflection Topic and/or Title(Required)

What is the focus of your reflection?

Scheduled Date for this Reflection(Required)

MM slash DD slash YYYY

Time for this Reflection(Required)

Hours

Minutes

AM/PM AM/PM

Have you reserved the room you want to use?(Required)

Yes, it is already reserved through EMS.

Yes, it is already reserved on the CCE community room calendar.

No, I still need to reserve a room and/or need assistance choosing a room.

Where will this reflection take place?(Required)

If you intend to have food, what is your plan for ordering?(Required)

Reminder to schedule a time to meet with her at least 2 days prior to the event. If you need suggestions or help, email or Teams message Felicia.

Reflection Materials

Check below the types of materials you need:(Required)

I need materials printed

I need help buying activity materials

I am getting materials and will need to fill out a reimbursement

I need something else, and will list it in the notes section below

I do not need anything for this reflection

Attach any documents you need printed and indicate in the "Notes for Materials" box below how many copies of each document you need.

Add detailed instructions in the “Notes for Materials” section below.

Drop files here or

Max. file size: 5 MB.

Notes for Materials(Required)

Please list all materials you need printed, how many, and what size. Label your file accurately to ensure proper printing. If you need supplies bought for an activity, list those as well. Reminder to stick to your $100/quarter budget when considering materials outside of food (all printing costs are covered by our department).

Outlining the Event

Describe why you have chosen this topic and what you intend for participants to learn from it.(Required)

Questions to consider: How does this intersect with my program? Why is this important for my participants to learn about or reflect on? When will my participants put these material/ideas/growth into action?

Does this reflection connect with any other reflections or events this quarter/year?(Required)

If yes please describe, if no please write “NA”.

Are you partnering with an external (non-CCE) campus department, student organization, or faculty?(Required)

Yes. They have confirmed and I will provide more information below.

Yes. I will provide more information below, but they have not yet confirmed.

No, it’s just me (and my co-CES, if applicable)

I am considering it, but not sure who or what would connect well with this topic and program(s).

Describe the collaboration and how the other group will be involved.(Required)

Do you need help finding catalyst materials?(Required)

Yes, I know what I want to discuss, but not where to start.

No, I have what I intend to use already.

What is your catalyst and how will you use it?(Required)

What will lay the foundation for an honest and complex conversation around this topic? List the media (article, video, art, etc) or other material will you use as the focus of your discussions.

Please list your discussion questions:(Required)

Think about your end goal. What do you want participants to understand or think about? Think about the amount of time you have and where both breadth and/or depth could be most impactful.

Which activities will you do with participants at this reflection?(Required)

Select all which apply

Start with an ice breaker / group bonding activity

Create through art/writing

Small group or paired discussions

Play a game to explore the focus topic or catalyst

Will you collect feedback from participants about reflection?(Required)

Yes, I will collect formal feedback through an online form, q&a at reflection, or written notes at reflection.

Somewhat, I will collect informal feedback in conversations with participants following the reflection.

I do not intend to collect feedback until the end of the quarter.

Making Reflection Meaningful

Please describe how you will facilitate participants interaction and engagement with your activities and catalyst?(Required)

Include a description of specific activities, intentions, and desired outcomes.

How will you connect this reflection topic to Kalamazoo communities we work/live with?(Required)

Consider local history, current populations, systems of oppression impacting our communities, current issues and/or initiatives in the area, and previous work in social justice movements.

Please explain how you will do to encourage participants to take action on what they have learned beyond this reflection event or outside of CCE programs.(Required)

Is there anything else you want to say or share about this reflection?(Required)

If you have a lesson plan for your specific catalyst, please attach it here.

Attach files which contain more details on how you will facilitate the catalyst learning. This may be teaching in any style, but which builds on questions answered above. Not required if your plans are explained elsewhere in this form.

Drop files here or

Max. file size: 5 MB.