CBE - Community Service Activities Report

COMMUNITY SERVICE ACTIVITIES REPORT

To better document the range and extent of community service activities of University of Connecticut medical students, the Office of Community Based Education has established this online recording method. Please provide your best estimate of the number of hours you volunteered for each project in which you participated. In addition, we ask that you indicate any leadership roles you contributed, including serving as manager, board member, in fundraising, etc. If you have any questions, please contact Stacey Brown or Judy Lewis in the CBE office.

Thank you.

First Name: Last Name: Start year of medical school: Year in program:
Program/Agency	Estimate Hours	If Leadership Role, State Type:
American School for the Deaf Health Education Program
Bridge to the Future: Science Mentorship Program
Community Partners in Action Mentoring and Health Education
Habitat for Humanity
Hartford Health Education Program
High School Health Professions Recruitment Exposure Program (HPREP)
Migrant Health Worker Clinic
Pediatric Scholars Reading Program
New Britain YMCA Cardiac Education Project
South Marshall Street Clinic
South Park Inn Clinic
Tar Wars
YMCA Adolescent Clinic
Youth Science Enrichment Program (YSEP)
Other: