Health Support Specialist Information Coming Soon!!!

Home

Outreach Health Support Specialist Forms

bullet Instructor Paperwork Agreement Form

This form is a checklist of paperwork that must be completed before, during and after an HSS course has been taught by the instructor. This form must be read thoroughly, signed and returned to the college before classes are taught.

bulletBooks Received form

To be filled out by the instructor or facility coordinator when books are distributed to students.

bulletClass/Course Scheduling form

To be filled out by the instructor or facility coordinator ten work days before class is scheduled to begin.

bulletDaily Class Roster

To be filled by instructor everyday of each class. This form is mandatory for the Department of Labor.

bulletInstructor Completion form

To be filled out by the instructor when class has been completed.

bulletStudent Admission form

To be filled out by the student when they begin the Health Support Specialist program. Students only need to fill out one admission form for the entire program.

bullet Student Demographics form

To be filled out by the student along with the admission form. This form is for statistical purposes only.

bulletDOL Grant Expense Voucher - PDF Format
bulletDOL Grant Expense Voucher - Word Format

To be filled out by instructors for travel expenses and meals when teaching an HSS course.

bulletPurchase Requisition

 

bullet Student Evaluation Form

 

bullet
Instructor Evaluation
 
 
bullet
NCKTC Syllabus Form
 
bullet
NCKTC Lesson Plan Form
 
bullet
NCKTC Purchase Req
                                              

 

 

 

Home