Outreach Report Form

Outreach Report Form

  • Name of the event or organization.
  • Number of hours working outreach. Please enter two decimal points when recording half hours. For example: 1.50
  • Audience Demographics

    Unless gathered though evaluation materials or audience's disclosures, this data is based on assumptions.
  • If this was not a tabling opportunity please enter 0 into this field.
  • Number of people in audience for speaking engagement. If you did not speak at an event please enter 0 into this field.
  • Materials Distributed

    Check all of the OV materials disseminated at event. In paragraph below, list the numbers of all materials distributed. (e.g. 50 English OV brochures)
  • Hold "ctrl" to select multiple options
  • Of the materials selected above, list the number of each material distributed (e.g. 50 OV English brochures)
  • You do not need to include a $ sign.
  • Price: $20.00 Quantity:
    Number of t-shirts sold.