After Activity/Program/Project REPORT (or Trip REPORT)

AHEC Personal Vehicle Use Justification

2009-2010 Budget and Closeout Template
Combined program budget and closeout form

CE Committe Members
Nurse Planner Members of PHNPD Continuing Education Committee

Contractor Request for Payment
UNC-CH Request for Payment of Independent Contractor--use with one of the 2 following forms:

• In State Contractors : Use with Contractor Request for Payment
• Out of State Contractors : Use with Contractor Request for Payment
• Independent Contractor Determination Checklist

Core Registration Fields
Revised core registration information

Course Cancellation Form

EPA Non-Faculty Evaluation

• Annual EPA Non-Faculty Performance Review April 2008
  
• Annual Review Self Assessment Form

• Guidelines for EPA Non-Faculty Performance Reviews April 2008
  
  

EPA Monthly Personnel Leave Record

Human Resources forms
Links to HR site where they have many forms online.

• HR Annual Performance Review
• Leave and Holidays

Journals
List of journals to which we can send notices of programs.

Letter of Agreement
Sample letters of agreement for scope of work

Breastfeeding Institute Scope of Work

Biostatistics Workshops Scope of Work

Letterhead Template
Letterhead template with the new UNC SPH logo.

Listflags and Label Jobs Central
Designed to facilitate the process of updating listflags and ordering labels from the database administrator.This link takes you to a new page.

Marketing Status Report

Marketing Work Order (the orange form): for Course Materials & Electronic marketing

Marketing Blue Form: Printing Work Order

Nursing

PHNPD Provider Directed Educational Activity Form
To be completed when offering Nursing Contact Hours for a program.

Computer Evaluation Form
To be used for programs offering Nursing Contact Hours.

PHNPD CNE Commercial Support Agreement

Guidelines for Writing Instructional Objectives

Nursing Contact Hours: Sample Agenda
To be used for programs offering Nursing Contact Hours.

Glossary of Terms
To be used for programs offering Nursing Contact Hours.

OCE Course Lists

Participant Confirmation Memo
Sample participant confirmation letter.

Personal Vehicle Usage Form
Requesting 0.55 per mile reimbursement for trip of more than 100 miles.

Pink Sheet

• Word version of pink sheet
• Onsite Pink Sheet : Initial course information form for land-based or web programs
• Videoconference Pink Sheet : Initial course information form for videoconferences
  

Program Planning Check List for PAs and PCs
Lots of details for PAs and PCs.

PID Fields
Excel template

PID Policy for NCIPH
PID policy and the list of PID contacts for each Program

Registration Form

• Onsite: Download, complete the bottom portion, copy and distribute to participants onsite.
• Phone: Telephone registration form to be used in the office.

Reporting form
New improved form in Word format.

Speaker Release Forms

• Speaker/Presenter Release Form
• Speaker Release Form Audiotape Notification

Staff Bio Form

Time chart summary

Travel form
Travel reimbursement form.

W-4 Withholding Form

• Federal
• North Carolina

Waiver Form
For taking photos of participants during a class or conference.

Photographs will be taken during this conference for promotional purposes related to training programs at the North Carolina Institute for Public Health.  If you object to the use of your picture, please let conference staff know. There is no compensation for the use of these photos.