NRS-425 COMMUNITY TEACHING PROJECT: TEACHING ACKNOWLEDGMENT FORM

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NRS-425 Community Teaching Project: Teaching Acknowledgment Form

NRS-425 Community Teaching Project: Teaching Acknowledgment Form
NRS-425 Community Teaching Project: Teaching Acknowledgment Form
This form acknowledges that the teaching presentation has been completed. Students must submit this form in the digital classroom in Topic 5.
Student Name:
Course Section and Faculty Name:
Date of Presentation:
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Representative Information
Representative Name :
 
 
 
 
Last
First
M.I.
Credentials:
 
Title:
 
 
(i.e., MS, RN)
Organization:
 
Phone Number:
 
Email Address:
 
Student Presentation Information
Type of Presentation:
PowerPoint presentation
Pamphlet presentation
Poster presentation
Infographic presentation
 Provider Acknowledgement
I ___________________________ acknowledge that ____________________________
 
(Representative’s Name)
(Student’s Name)
has participated in a community teaching experience at the organization 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.  NRS-425-RS-T5-TeachingAcknowledgmentForm
 
 
 
Representative’s Signature (must be handwritten)
 
Date Signed
 

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