Community Teaching Work Plan Proposal

Note: This is an individual assignment. Applying what you have learned thus far, develop a community teaching proposal designed to address the needs of your community.

Select one of the following as the focus for the teaching plan:

1. Primary Prevention/Health Promotion
2. Secondary Prevention/Screenings for a Vulnerable Population
3. Bioterrorism/Disaster
4. Environmental Issues

Complete the “Community Teaching Work Plan Proposal.” This will help you organize your plan and create an outline for the written assignment.

1. After completing the teaching proposal, review the teaching plan with a community health and public health provider in your local community.
2. Request feedback (strengths and opportunities for improvement) from the provider.
3. Complete the “Community Teaching Experience” form.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

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:
FORMCHECKBOX PowerPoint Presentation	FORMCHECKBOX Pamphlet Presentation	FORMCHECKBOX Audio Presentation	FORMCHECKBOX 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