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:

ORDER A PAPER HERE

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