Graduate Certificate in Community Health Education (20 Hrs.) Community Health Education Graduate Certificate Education Plan PART A: DECLARATION _____________________________________________________________ Name (Please Print) ______________________ UIN ____________________________________________________________________________________________ Street Address ____________________________________________________________________________________________ City, state and Zip ____________________________________________ _____________________________________________ Phone Number e-mail REQUIRED COURSES Semester/Year Semester/Year Proposed Taken Grade *MPH 506 Community Health Research _____________ ____________ _________ MPH 508 Program Evaluation for Health Professionals _____________ ____________ _________ MPH 531 Public Health Policy AND ADMINISTRATION _____________ ____________ _________ MPH 561 Community Health Education _____________ ____________ _________ MPH 441 Human Well Being _____________ ____________ _________ The signatures below indicate that the student’s Educational Plan has been approved by the MPH Program. __________________________________________________________ Student __________________ DATE __________________________________________________________ Adviser __________________ DATE PART B: CONFIRMATION OF COMPLETION __________________________________________________________ Student __________________ DATE ___________________________________________________________ Adviser __________________ DATE ___________________________________________________________ MPH PROGRAM CHAIR __________________ DATE *Prerequisite: MPH 503 Biostatistics or an approved statistics course