1. Site of Program
Student Name and Class

2. How did I get involved with this experience?

3. Focus/Purpose of Project

4. What did I do?

5. Pictures
Pictures should be of relevant medical situations and local colleagues (not tourist photos)

6. A typical day

7. Pictures
Pictures should be of relevant medical situations and local colleagues (not tourist photos)

8. What did I learn?

9. Pictures
Pictures should be of relevant medical situations and local colleagues (not tourist photos)

10. Acknowledgements

11. Contact information
Program: Student: Host mentor: