CampusLife - Program OTM

Program OTM Form

Month/Year of Program:	mm/dd/yy
OTM Category:
Program Title:
Program Coordinator:

Nominee Name:
Nominee Addr:
Nominee Email:
Nominee Phone:

Nominator Name:
Nominator Addr:
Nominator Email:
Nominator Phone:

No: of Target Population:
No: of Attendees:
No: of Organizers:
Needed Organize Time:
Dates of Program:
Cost of Program:

Short Description:
	Enter upto 400 words
Origin of Program:
	Enter upto 200 words
Goals of Program:
	Enter upto 200 words
Positive and Lasting Effects of the Program:
	Enter upto 200 words
Short Evaluation of Program:
	Enter upto 200 words
How could this be adapted on other campuses?:
	Enter upto 200 words