P.I.A Submission
This is the Gamma Alpha Sigma Chapter Program Implementation Assessment Form. Please be sure to fill in every box to the best of your knowledge and also be sure to submit your documentation also.
Full Name
*
First Name
Last Name
Email
example@example.com
Date of the Event
*
-
Month
-
Day
Year
Date
Program Focus Area
*
Please Select
Bigger and Better Business
Education
Membership
Sigma Beta Club
Social Action
Is this a Good Health Wins Event?
Please Select
YES
NO
Is this a Black Spend Event?
Please Select
YES
NO
If this was a Black Spend event, enter the amount.
Ex: $100.00
How long was the Event?
*
In Hours
# of brothers present at the event.
*
# of Service Hours
*
Ex: 2 brothers present for 5 hours = 10 service hours
Where did the event take place?
*
Location Name: Maple Heights Library
Program Description
*
Ex: Monthly Committee Meeting / Chapter Meeting
Program Goals
*
Ex: Increase Member engagement through …
Was this event held w/ the sisters of Zeta Phi Beta?
*
Please Select
YES
NO
Rate the events success.
*
Please Select
Excellent
Good
Fair
Poor
Did we disburse funds?
*
Please Select
YES
NO
Was it for a scholarship or donation?
Should we do it again?
*
Please Select
Yes
No
Maybe with improvements
Take Photo
Was there any media from the event
Browse Files
Pictures, Flyers, or Videos
Cancel
of
Submit
Should be Empty: