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Thank you for submitting your PACT Program Attendance Log!  As you know, we rely on this information to help support you throughout your program.  This form also helps us track the number of children and families participating in our programs, as well as the amount of time that you are donating.

Please complete the form below and submit it each week, for the duration of your program.  If you have any questions or if you need anything from the program staff at Free Arts, do not hesitate to call us at (310) 313-4278 or click here to email Katherine.

Thank you!

 

 

First Name *
Last Name *
Agency Name *
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Please list the agency where you deliver your program
Week *
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Please list the session number
Date of the session you are reporting *
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The date you were at the agency leading the program
Session # *
Agency staff name *
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The name of the agency staff member who was in the room with you
Total # of kids participating this week *
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How many kids participated in your program just this week?
How many kids were NEW to the group? *
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Please just list the number of children who had not participated in your program prior to this week
Total # of adults participating this week *
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How many adults participated in your program just this week?
How many adults were NEW to the group? *
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Please just list the number of adults who had not participated in your program prior to this week
Total # of families participating this week *
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How many families participated in your program just this week?
How many families were NEW to the group? *
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Please just list the number of families who had not participated in your program prior to this week
Description of this week's art activity *
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Please summarize the activity that you led this week
How much time did all volunteers spend preparing for this week's session? *
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Please indicate the time contributed by all volunteers involved with this program
How much time did all volunteers spend at the agency facilitating the project this week? *
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Total amount of time for all volunteers who were on-site leading the program this week
Please provide a brief story, quote or reflection about this week's session *
Please share any questions, concerns, needs or thoughts with the Free Arts Program Coordinator
E-mail Address *

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