MASH Assistant Evaluation MASH Director Name(Required) First Last MASH Camp Location(Required)Choose your campMASH Camp – Mercy Hospital in Fort Smith, ARMASH Camp – Baptist Health Hospital in Fort Smith, ARMini-MASH Camp – CHI St. Vincent Hospital in Hot Springs, ARMASH Camp – Baptist Health Medical Center, Hot Spring County, Malvern ARMASH Camp – UAMS South Central Campus, Pine Bluff, ARMASH Camp – Arkansas Northeastern College (ANC), Blytheville, ARMini-MASH Camp – Chicot Memorial Center in Lake Village, ARMASH Camp – Ashley County Medical Center, Crossett, ARMini-MASH Camp – UAMS Campus Northeast, Jonesboro, ARMASH Camp – Mercy Hospital Northwest, Rogers, ARMASH Camp – UAMS Northwest Campus – Fayetteville, ARMini-MASH Camp – Mena Regional Health System – Mena, ARMini-MASH Camp – Baptist Memorial Hospital – West Memphis, ARMASH Camp – Delta Memorial Hospital – Dumas, ARCHAMPS Camp –Ashley County Medical Center – Crossett, ARMini-MASH Camp – Ozark Health Medical Center – Clinton, ARMASH Camp – UAMS Southwest – Texarkana, ARMASH Camp – Arkansas Methodist Medical Center – Paragould, ARMini-MASH Camp – Baptist Health Medical Center – Arkadelphia, ARMASH Camp – North Arkansas Regional Medical Center – Harrison, ARMini-MASH Camp – South Arkansas Regional Hospital and South Arkansas Community College – El Dorado, ARMASH Camp – De Witt Hospital – De Witt, ARMini-MASH Camp – Conway Regional Medical Center – Conway, ARMini-MASH Camp – Phillips Community College of the University of Arkansas – Helena, ARMini-MASH Camp – White River Health – Batesville, ARMini-MASH Camp – Cabot High School – Cabot, ARMini-MASH Camp – Bradley County Medical Center – Warren, ARMini-MASH Camp – Forrest City Medical Center – Forrest City, ARCamp Start Date(Required) Month Day Year Camp End Date(Required) Month Day Year Student Name(Required) First Last The student attended all required program dates(Required)Choose oneOutstandingAbove AverageAverageBelow AverageUnsatisfactoryThe student demonstrated professionalism throughout the program.(Required)Choose oneOutstandingAbove AverageAverageBelow AverageUnsatisfactoryThe student followed all instructions provided by the MASH Director.(Required)Choose oneOutstandingAbove AverageAverageBelow AverageUnsatisfactoryThe student effectively led assigned activities as directed by the MASH Director.(Required)Choose oneOutstandingAbove AverageAverageBelow AverageUnsatisfactoryThe student engaged positively and appropriately with the MASH participants.(Required)Choose oneOutstandingAbove AverageAverageBelow AverageUnsatisfactoryPlease provide any additional comments on the student’s overall performance, including strengths, areas for growth, or notable contributions.(Required)
