MEPAP I - Practicum Advisor Assignment: Student …

1 Activity Directors Network 2010 Hwy 190 W. #120. Livingston, TX 77351. MEPAP I - Practicum Advisor assignment : Find Advisor Student Information Student Name:_____ Course ID#: ME1-_____. Address:_____City/State/Zip: _____. Telephone:_____Fax:_____. E-Mail:_____. Practicum Advisor Information The Practicum Advisor must sign off on all of your Practicum assignment tasks included in your midterm & final Practicum packs as they are completed and be able to meet with you at least once a week to discuss the Practicum tasks. Forgery will not be tolerated and will result in immediate dismissal from the program without refund.

2 Activity Directors Network reserves the right to contact your Advisor at any point during or after your course completion in order to verify the Practicum tasks are being completed in the appropriate manner. Please provide valid Advisor contact information below. Practicum Facility Name: _____. Practicum Advisor Name: _____. Practicum Advisor E-mail:_____. Practicum Advisor Contact Phone Number: _____. Advisor Credentials You must find an Advisor that meets one of the following requirements: Activity Director Certified (ADC) ADC#_____. Activity Consultant Certified (ACC) ACC#_____.

3 Certified Therapeutic Recreation Specialist (CTRS) CTRS#_____. a Department Head with at least 5 years of experience Start Date:_____/_____/_____. or the Administrator. Facility Address:_____City/State/Zip_____. Telephone:_____Fax:_____. Student Signature:_____Date:_____/_____/_____. Practicum Advisor Signature:_____Date:_____/_____/_____. Activity Directors Network Toll Free: 1-888-238-0444. Fax: 1-866-405-5724. E-Mail: Page 1 of 2. Activity Directors Network 2010 Hwy 190 W. #120. Livingston, TX 77351. MEPAP I - Practicum assignment : Find Advisor Subject: Facility mission and organizational structure, Accountability, & Communication Project Description Advisor Student Practicum Tasks to Complete Date Initials Initials 1.

4 Set up an appointment with your Administrator to discuss the MEPAP course. 2. Discuss the MEPAP course objectives, personal learning goals. Ask the Administrator's expectations from the Student during and after the MEPAP course 3. Request information on the agency's mission statement and organizational chart. (attach to this Practicum requirement). 4. Write a summary of the meeting. Describe the Administrators response, both spoken and intuitive and what you learned Request a copy of Activities job descriptions and appropriate policies and procedures, organizational chart for the activities department for your resource book.

5 We do not need a copy of these forms, this is simply for your knowledge and your records. Practicum Advisor Comments/Notes: _____. _____. _____. _____. _____. _____. _____. _____. Student Signature:_____Date:_____/_____/_____. Practicum Advisor Signature:_____Date:_____/_____/_____. Activity Directors Network Toll Free: 1-888-238-0444. Fax: 1-866-405-5724. E-Mail: Page 2 of 2.