Center for Community Engaged Learning

Community Engaged Leader Program History Form

Program Name: 

Program Date(s): 

Your Contact Information

First Name: 

Last Name: 

Email Address: 

Phone Number: 

Address: 

City: 

State: 

Zip: 

Community Partner Contact Information

First Name: 

Last Name: 

Email Address: 

Phone Number: 

Address: 

City: 

State: 

Zip: 

Key Contact

First Name: 

Last Name: 

Email Address: 

Phone Number: 

Address: 

City: 

State: 

Zip: 

Program Description
Please describe the program (what happened?)

Program Structure

Who made things happen and what were their tasks?

Timeline

Volunteers
Include names and email addresses for all volunteers.

What was the purpose of your program?

What was the best part of your program?

How did you advertise?

How could your advertising have been better?

How were your volunteers used?
Give specific assignments that you gave the volunteers.

What went well during the program?

What needs improvement?

Budget

Please list your expenses for the following areas:

Advertising: 

Equipment: 

Food: 

Supplies: 

Transportation: 

Other: 

Recommendations
Changes to the program description, changes to the program structure, additional contacts that might be helpful, changes to the budget (does the program need more or less money and why), changes to the timeline, etc.

Forms
Email all forms to Mike at mikemoon@weber.edu. Include examples of waiver forms, applications, and evaluation forms from participants, or any other pertinent information.


Publicity
Email all originals of fliers, press coverage, etc. to Mike at mikemoon@weber.edu. Also, include any pictures.

 

Upon the successful completion of this form, you will be automatically directed to the Community Engaged Leaders page. You will contacted regarding this form within 2 to 3 business days.

 



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