Substance Abuse Prevention Education Fund
Program Evaluation
Name of Program:
*
Date program was held:
*
-
Month
-
Day
Year
Date
Coordinator of Program:
*
First Name
Last Name
Coordinator Email:
*
example@example.com
Coordinator Phone Number:
*
Please enter a valid phone number.
Format: (000) 000-0000.
Types of Publicity/Promotions Used:
*
Collaborators/Partnerships/Contributors:
*
Total cost of program (USD):
*
SAPE Funding (USD):
*
Used for:
*
Number of students reached
*
Is this the actual number or an estimate
Actual number
Estimate
Description of alcohol and other drugs education (messages/activities):
*
Outcomes:
*
Would you want to do this program again
*
Yes
No
Why not?
*
Would you make any changes next time?
*
Submit
Should be Empty: