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Community partner visit form
1.
Community Partner Site Visit Information Date/Time of Meeting: Location of Meeting: Name and Title of Agency Representative: Agency Name: Agency Mission Description: Is the agency partnered on the Pomerantz Career Center’s Hire‐a‐Hawk website (to post job, internship and volunteer opportunities)? ____ Yes ____ No _____ If no, does the agency wish to be? Is the agency partnered with the UI on VCJC website (UI dome medallion on agency’s listing)? ____ Yes ____ No _____ If no, does the agency wish to be? Partnerships with the UI (include name of staff or faculty name/department or unit and general details) Code: E = existing; D = desired _____ Volunteers, episodic and/or ongoing _____ Service‐Learning _____ Internships _____ Practicum/Preceptor Experiences _____ Work‐Study _____ Community‐Based Research _____ Other
2.
What was the agency’s most recent collaboration with a UI group? What went well? What didn’t go well? Does the agency have future projects on their wish list with which they would like to involve UI faculty or students? (Projects can be large or small, but something that is not an urgent need.) _____ (Yes, details below.) Follow‐Up Plan:
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