RA Program Self Evaluation
Name
*
Chosen Name (First Name)
Last Name
Email
*
Building
*
Please Select
Atlantic
Bowditch
Forten
Marsh
Peabody
Was this your Solo ACCESS Program, Program Partner ACCESS Program, Door-to-Door Program, or Half/Tri Staff Social Program?
Solo ACCESS Program
Program Partner ACCESS Program
Door to Door Program
Half/Tri Staff Social Program
Program Partner Name
*
(Chosen Name) First Name
Last Name
Please type in who all your Half/Tri Staff Program Partners were
*
0/0
Program Title
*
Date of Program
*
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Number of Residents in Attendance
*
Type how many residents attended this event
ACCESS Model Viking Value
*
Academics
Community
Self Exploration
Social Justice
Wellness
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Overall Self-Assessment of the Program
*
Excellent
Good
Fair
Needed Improvement
Other
Rationale Behind Rating
*
0/0
Overall Self-Assessment of the Collaboration with Program Partner or Half/Third Staff Partners
*
Great Communication and Collaboration
Fair Communication and Collaboration
Needed Improvement on Communication and Collaboration
Nonexistent Communication and Collaboration
Other
Rationale Behind Rating
*
0/0
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Describe how your residents engaged your program
*
0/0
What would you do differently if anything, if you were to plan and execute this program again.
*
0/0
What would you change if anything, to improve upon the planning and execution for the next program you plan to host?
*
0/0
If you have any images from the event please upload them.
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If this program does not have any concerns with the need to be confidential in nature, please upload pictures if you have them.
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