Date*

Staff Member*

If multiple staff are at the same presentation, select multiple staff.

Other/Volunteer

Program*

Select a program from the list that best fits this event.

Outreach Information

Type of Outreach*

Outreach Delivery*

Group Information

Group Type*

Only select school if the presentation is specifically for students or school staff at a specific school. An ISD group should be community.

Name of Group/Organization/School/Event*

District*

If not a school, please enter "N/A". If this is a district wide presentation, please list the appropriate ISD.

School Classification*

If not a school, please select "community group".

School Level*

Select Multi-Grade for schools that have lower and upper schools on their campus. If not a school, please select "community group".

Grade Level (i.e. 3, 4, 5)*

If students were not reached, please enter "N/A".

Location Address*

IMPORTANT: If this was a virtual presentation or if information was emailed, please enter the address of the group not the Crime Stoppers address. Only enter the Crime Stoppers address if this was a Crime Stoppers hosted event.

Materials Provided

Enter actual or potential reach below just as you would a normal presentation/outreach. If materials were provided during a presentation do not duplicate actual reach.

Were any materials provided?*

Total # of Unsponsored Materials Provided*

If no materials were provided, enter zero.

Presentation Information

English or Spanish*

SCI Presentation/Training Topic

SSI Presentation/Training Topic

SSI Statewide Presentation/Training Topic

Actual Reach

Enter the total actual reach for all outreach types in this entry. Actual reach for material drops can be counted in Community/Parents. If one of the demographics were not reached, please enter "zero".

Students*

School Staff/Law Enforcement*

Community/Parents*

Potential Reach

Enter the potential reach for all outreach types in this entry.

Potential Reach*

List potential reach for fairs, outreach events and/or materials left for non-attendees where the exact number of participants is unknown. If there was not a potential reach, please enter "zero".

Extras

Notes

Enter any notes that may help explain any part of this entry and/or topics of material drops.

Truck - Total mileage