Public Health GEC: Co-Curricular Community Engagement Completion Form

Thanks for participating in the Public Health GEC co-curricular community engagement option. This form must be completed and submitted upon completion of the project.

PLEASE NOTE: After completing this form, your final responsibility is to ensure your community partner confirms and provides feedback on your work. You should graciously request that they complete this confidential feedback form at their earliest convenience.

Your (student's) name:*
First Last
Brief description of the community-engaged option you completed (What? Where? When?)*
If there were any significant departures from the project as you originally proposed it, please explain those departures here:*
Your community partner's name, organization, and email address (and don't forget to send the feedback form mentioned above to your community partner!):*
Name
This field is for validation purposes and should be left unchanged.

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