Program Partner Completion Form

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Program Partner Completion Form

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Program Partner(Required)

Program Title(Required)

When and where was program conducted?(Required)

Contact(Required)

Email(Required)

Phone

Mailing Address for Check(Required)

Street Address Address Line 2 City State ZIP Code

Make Check Payable to:(Required)

Amount Requested(Required)

Agreement(Required)

I verify that the above named program has been successfully completed according to the parameters set forth in the application. If there were any alterations to the original program, these were approved by the school and have been noted below.(Required)

Your Name(Required)

Date(Required)

MM slash DD slash YYYY

Signature(Required)

Feedback

How would you rate the success of your program using the rubric below?

5 – Students were enthusiastically engaged

4 – Students were mostly engaged

3 – Students were somewhat engaged

2 – Students were not very engaged

1 – Students were not engaged

What did the students seem to especially enjoy about your program?

When, if ever, did students start to lose interest?

How many students ultimately participated in the program by grade level?

Did you feel you had good teacher/administration support to deliver your program successfully?

What, if anything, would you like to see done differently if presenting your program again?

How can Arts, etc. help you succeed?

Marketing

Tag our foundation on all social media posts related to the funding.
Provide photos and videos for our organization. Include signed media release forms from all students and adults in the footage agreeing that we may use them for promotional purposes.

Measuring Results

Finally, if you have any information or quantitative information to share with Arts, etc. that would indicate the positive impact your program has on student learning, we would be most appreciative to receive.

We hope to share the powerful impact of the arts on student learning with our community partners. Thank you very much for delivering your program!

This field is for validation purposes and should be left unchanged.