Evaluation/Impact Tracking Activity Tracking Report Please use this form to input any outreach event/activity data to calculate program impact. For questions or concerns, please contact Megan Hasting at hasting.6@osu.edu or (614) 688-4285. First and Last Name * Activity/Event Type * Curriculum Short-Term Outreach Activity Long-Term Outreach Activity Social Media Outreach Activity/Event Title Curriculum Title Social Media Outreach Type (choose all that apply): Facebook Twitter Instagram LinkedIn BlogBlog OtherOther Activity/Event Primary Audience Type K-12 Educators Elementary Students Middle School Students High School Students Community-at-large OtherOther Curriculum Description How would you characterize the curriculum type? What grade level is it most suited for? What is the format of the curriculum (.pdf, web link, video, etc.)? The description you provide will be used on the curriculum repository website, so please be as specific and detailed as possible. Have you used this curriculum in your classes? Yes No Not yet, but it is scheduled. How many students have you taught this curriculum to? What was the outcome of using this curriculum in your classroom? How did students respond? Activity/Event Description Please be as specific as possible. What was the primary goal of the activity/event? When was it held? Where? Describe the impact of the activity/event on its primary audience. Audience Attendance Numbers Other comments, qualitative or quantitative data, or details you'd like share: Website/URL of social media post (if any): Please upload any files associated with your event/activity or curriculum (attendance records, presentation guide, lesson plan, etc.) Drop a file here or click to upload Choose File Maximum file size: 52.22MB This form is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply. Δ