Program Implementation Assessment Form
(Minimum required fields marked with an asterisk(*). Other fields may be required based on input.)
* Program area focus:
* Calendar Year:
* Date of event:
* Number of service hours of event:
* Venue Activity Location:
* Program Description:
* Program Goals:
* # People provide materials:
* # Members participated event:
National Partner fundraising event:
Health event:
Bigger Better Business event:
Education event:
Outside moderator/speaker:
Last scholarship funds dispers:
Were funds dispersed?
Dispursement Type:
Funds Recipient: Other:
Amount Disbursed:
Type of media coverage:
Event Pictures:
Picture Comments:
Event Video:
Video Comments:
* Rate event success:
* Recommended program in future:
Additional Comments:
Additional Documentation: