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activity Report for previous school year

Fill out, print and fax or mail to TAME office:

TAME, Inc., UT-Austin, R9200, 10100 Burnet Road, Bldg 16, Rm 10

Austin, TX  78758  PH: 512-471-6100   FAX: 471-6797

Numbers below must represent totals for local participation over the past academic year 

                                     For the Academic Year: 

VOLUNTEERS

Number of Teacher Volunteers:  

Number of Corporate Volunteers:  

Number of Government Agency Volunteers:

Number of College Volunteers:

Number of Other Volunteers:

Total Number of Volunteers:

Total Number of Volunteer HOURS:

SCHOOLS & STUDENTS

Number of School Districts:  

Number of Elementary Students:

Number of Middle School Students:

Number of High School Students:

* Total Number of Students:      Total Male        Total Female

* Numbers should not include those students who came to the State Math/Science contest or any State provided trailer tour event as the Central office already records that information.

Student Ethnicity Breakdown

 African American     Hispanic American

Native American      Asian American       Other

Please tell us about the programs you provided to students in your area during the previous school year:

EVENT #1

Title of event/activity:     TOTAL NUMBER OF PARTICIPANTS:

 

Description of event/activity:

 

Evaluation (was it successful?  What would you change if you chose to hold this event again?)

 

EVENT #2

Title of event/activity:     TOTAL NUMBER OF PARTICIPANTS:

 

Description of event/activity:

 

Evaluation (was it successful?  What would you change if you chose to hold this event again?)

 

EVENT #3

Title of event/activity:     TOTAL NUMBER OF PARTICIPANTS:

 

Description of event/activity:

 

Evaluation (was it successful?  What would you change if you chose to hold this event again?)

 

EVENT #4

Title of event/activity:     TOTAL NUMBER OF PARTICIPANTS:

 

Description of event/activity:

 

Evaluation (was it successful?  What would you change if you chose to hold this event again?)

 

EVENT #5

Title of event/activity:    TOTAL NUMBER OF PARTICIPANTS:

 

Description of event/activity:

 

Evaluation (was it successful?  What would you change if you chose to hold this event again?)

 

EVENT #6

Title of event/activity:    TOTAL NUMBER OF PARTICIPANTS:

 

Description of event/activity:

 

Evaluation (was it successful?  What would you change if you chose to hold this event again?)

 

EVENT #7

Title of event/activity:    TOTAL NUMBER OF PARTICIPANTS:

 

Description of event/activity:

 

Evaluation (was it successful?  What would you change if you chose to hold this event again?)

 

EVENT #8

Title of event/activity:    TOTAL NUMBER OF PARTICIPANTS:

 

Description of event/activity:

 

Evaluation (was it successful?  What would you change if you chose to hold this event again?)

 

All information submitted is accurate to the best of my knowledge.

Name of submitting alliance officer:  

Title: