Community Teaching Plan: Community Presentation

Community Teaching Plan: Community Presentation

PowerPoint presentation – no more than 30 minutes Pamphlet presentation – 1 to 2 pages Poster presentation

Appropriate community settings include:

Public health clinic Community health center Long-term care facility Transitional care facility Home health center University/School health center Church community Adult/Child care center

 

Community Teaching Experience

 

 

Students must submit this form as part of the assignment submission.

 

Student Name:__________________						Course Section & Faculty Name:_____________________________
Date of Presentation:_____________
Provider Information
Provider Name :
Last								First			M.I.
Credentials:						Title:
(i.e., MS, RN, etc.)
Organization:
Phone Number:
E-mail Address:
Student Presentation Information
Type of Presentation:
PowerPoint Presentation				Pamphlet Presentation				Audio Presentation		Poster Presentation
D
Provider Acknowledgement

 

 

 

I __________________________acknowledge that ____________________________

(Provider Name)                                                         (Student Name)

 

has requested approval to participate in a community teaching experience at the location listed on this form. The organization / agency does not endorse the university or the student however, the teaching plan developed by the student is considered appropriate and of benefit to the community of interest.

 

 

 

 

 

______________________________                                                _________________

Provider Signature                                                                                  Date Signed

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