Health Education Leadership Program
APAMSA 2009-2010
COMMUNITY OUTREACH INITIATIVE
HEALTH EDUCATION LEADERSHIP PROGRAM
COI-HELP TEMPLATE
HMONG AMERICAN FRIENDSHIP ASSOCIATION
SHEE YEE COMMUNITY
ASIAN HEALTH & RESOURCE FAIR
APAMSA-MCW BLOOD PRESSURE SCREENING
In the following textbox, please provide a list of your student task force officers and their contact information: (e.g., Jane Doe: ; John Doe: ;...etc.).
======
======
In the following textbox, please identify and list the goals and objectives (at least 2 for each category) for your community project.
======
======
In the following textbox, please provideyour list of student task force officers, their assigned task force role(s), and their contact information (e.g., Jane Doe, coordinator: ; John Doe, communications: ;...etc.).
======
======
In the following textbox, please identify and list the key representatives of your support system and their contact information: (e.g., Dr. Jane Doe, family practitioner, Doe Family Medical Center, 1000 1st Street, City, State ZIP, 444-444-4444: ; Mr. John Doe, health education director, Asian Pacific American Organization, 1001 1st Street, City, State ZIP, 555-555-5555: ;...etc.).
======
======
In the following textbox, please provide a timeline including the specific dates ((Date: xx/xx/20xx) for each task in your planning schedule.
======
======
In the following textbox, please provide budget plan for your community project.
======
======
In the following textbox, please briefly describe the theme for your community project (40-word limit).
======
======
In the following textbox, please identify your content type (i.e., awareness, screening, hands-on),the health topic(s) addressed, and the type of project content (e.g., handouts, lecture slides, public service announcement, news article,…etc.) used for your community project.
======
======
File submission
Please submit all project content files (e.g., handouts, lecture slides, public service announcement, news article,…etc.) as e-mail attachments sent to (Subject heading: “Project Content + <chapter name> + <event name>”).
======
In the following textbox, please identify the event location for your community project (i.e., venue name, address, driving directions, parking instructions), describe the accommodations needed for each provider, and list the accommodations available at this venue.
======
======
In the following textbox, please describe your event floor plan in regards to thespace needed, anticipated traffic flow, and the location of electrical outlets, the registration table, screenings, demonstrations, and signs for your community project.
======
======
In the following textbox, please list the providers and sponsors for your community project (i.e., organization name, contact name), describe their services (e.g., provided flat screen television for raffle/hosted information booth/blood pressure screening), and their contact information (i.e., contact address, phone number, e-mail)
======
======
In the following textbox, please list any incentives and raffle items collected for your community project, identify the organizations and contact persons responsible for contributing these items (i.e., organization name, contact name,contact address, phone number, e-mail), and a brief description of how incentives were provided and/or how your raffle was conducted.
======
======
In the following textbox, please list the names and contact information (e.g., John Doe, staff officer, ; Jane Doe, volunteer, ;...etc.)of all staff officers and volunteers for your community project.
======
======
In the following textbox, please provide an example of your advertisement message,a descriptionthe promotional methods used (i.e., posters, flyers, e-mail, internet postings), anda listof contacts who helped promote your community project (i.e., Jane Doe, director of listserv, distributed event announcement to all hospital staff via e-mail, ).
======
======
In the following textbox, please provide a copy of your (1) Participant Evaluation Form and (2) Provider Evaluation Form.
======
======
In the following textbox, please provide a copy of your Event Summary Report for your community project.
======
======
======
File submission
Please submit a few pictures capturing the spirit of your community project as e-mail attachments sent to (Subject heading: “Event Pictures + <chapter name> + <event name>”.
======