HomeSurvey Response

Fatherhood & Mentoring Page 1 of 2

Page 1

Chapter Name

Submitter Name

Submitter Phone

Submitter Email

Activity Name

Activity Date

Activity Description

You may copy(ctrl+c)and paste (ctrl+v) text into this space .

Total Participants

Total Students Impacted/Attended

Total Young Adult Fathers (non-Omegas) Impacted/Attended

Total Omega Brothers in Attendance

Total Community Collaborative Partners

List the Collaborative Partners

Number of Students That Have Participated in Multiple Activities

Number of Elementary School Students

Number of Middle School Students

Please provide the detailed budget for the activity (Line item = $Cost)

Although sharing this financial information is optional, this data may help other chapters in replicating the activity in the various regions around the Second District.

Number of High School Students

Please list the total budget/cost for this activity

Submit Article Text Here

You may copy(ctrl+c) and paste (ctrl+v) text into this space.

Cancel Next