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Student Project Approval Form

Is this a Category A (Peer Health Presentation) or Category B (Creative Health Project).

Title (or topic):
Name of your school:
Faculty Advisor Name:
Project description:
Information Sources:
List up to three you plan to use in doing research for this project, e.g., Web sites, books, periodicals, or other informational sources.
Project Location:
Where and when will project occur, (dates, times, locations, even if you are currently guessing. (Example, Terre Haute YMCA, 123 Main St, Terre Haute 12345) 		Where:
Date:
Time:
Name of student(s)
working on project:		 Last Name: First Name:
Last Name: First Name:
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  Last Name: First Name:
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Contact for this project: Last Name: First Name:
Contact email address:

Please review your information. Whey you are ready, click Submit and your information will be submitted to the INSight Yourth Corps projectmanagement team.

You will receive a confirmation email.