Public Outreach Education: After

POE Post-Activity Report

POE Post-Activity Report

Event

Event Address
Event Address
City
State/Province
Zip/Postal
Country

Activity Info

What was the medium or format: Live or Virtual?
Type of Event
Topics Covered

Comment

Where there stories of interest from the participants? How many?
How many? (up to four)

Tell us about what happened! We want to know more...

Please Note

This form is to be completed AFTER outreach has been conducted (tabling event, presentation, training, brochure distribution, radio/TV interview, etc.)

Copies of data submitted to this form will forward to the volunteer filling out this form, as well as to info@endoflifeoptionsnm.org