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Mutual Aid Group Facilitator Weekly Report
To be filled out weekly by each mutual aid group facilitator
Name
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Start date
*
-
Month
-
Day
Year
Date
End date
*
-
Month
-
Day
Year
Date
How many mutual aid groups did you supervise during this week?
*
1
2
3
4
5 or more
Please indicate the dates on which you visited the mutual aid group at their workplaces and how many hours were spent at the workplaces to monitor the work of the mutual aid groups during this week.
*
Visit Date 1
Visit duration 1
Visit Date 2
Visit Duration 2
Date Visit 3
Visit Duraion 3
Group 1
Group 2
Group 3
Group 4
Group 5
group 6
Group 7
Group 8
Group 9
Group 10
PLEASE UPLOAD A SHORT VIDEO SHOWICASING YOUR ON-SITE VISITS OF THE MUTUAL AID GROUP AS WEL AS THEIR WORK DURING THIS WEEK.
*
Browse Files
Cancel
of
PLEASE UPLOAD A SHORT VIDEO OR PICTURES SHOWING YOUR VISITS WITH PARTENERING ORGANIZATIONS DURING THIS WEEK.
*
Browse Files
Cancel
of
How many new local partnering organizations or businesses did you contact this week?
How many of the organizations or businesses you have contacted became a partnering organization this week?
How many hours did you spent calling on and finding new local partnering organizations and businesses?
Provide the dates you contacted or visited these organizations, the number of hours spent visiting these organizations, the names of these organizations as well as the emails and phone number of the person you have contacted in the organization.
*
Date
Work
Email
Phone number
Organization 1
Organization 2
Organization 3
Organization 4
Organization 5
Organization 6
Organization 7
Organization 8
Organization 9
Organization 10
Provide for each organization that accepted to become a partner a short description of its business activity, the type of work the mutual aid group members will be providing and what skills or talents or apprenticeship learning the mutual aid group members will acquire
Name of the mutual aid group facilitator
*
First Name
Last Name
Submit
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