Chapter Program End-of-the-Year Report Form
Complete this form and submit for your committee.
Program Name:
Committee Chair Name:
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Programmatic Thrust Addressed:
National/Regional Initiative Addressed:
Activity/Event Name:
Purpose:
Program Objective(s):
Date of Event(s):
Location of Event(s):
Virtual
Face-to-Face
Hybrid
Provide Specific Details for Location of Event(s):
Population Served (demographics): Number of Participants? Age Groups?
Include the following: Number of participants? Age groups?
Community Partners/ Collaborations:
Include the following: Number of partners? List the name of all partners.
Number of Service Hours:
Summary of Activity:
Back
Next
Save
Budget:
Include the following: Amount requested? Amount rewarded? Amount Utilized?
Methods of Evaluation (include summary of evaluations/feedback):
Attachment:
Browse Files
May include flyers, marketing tools, articles, press releases, pictures, etc.
Cancel
of
Attachment:
Browse Files
May include flyers, marketing tools, articles, press releases, pictures, etc.
Cancel
of
Attachment:
Browse Files
May include flyers, marketing tools, articles, press releases, pictures, etc.
Cancel
of
Attachment:
Browse Files
May include flyers, marketing tools, articles, press releases, pictures, etc.
Cancel
of
Attachment:
Browse Files
May include flyers, marketing tools, articles, press releases, pictures, etc.
Cancel
of
Back
Next
Save
Name(s) of Committee Members(s):
Committee Accomplishments:
Long-term Committee Plans:
Are you interested in chairing this committee again?
Yes
No
If answered "no," then please list others that would be a great candidate to chair this committee.
Do you have a standing conflict with Chapter or Executive Board Meetings? If "yes," please explain?
Notes:
Save
Submit
Print Form
Should be Empty: