Targeted Program Plan

Complete this form and submit it to your supervisor for approval. Your completed form will be delivered to the supervisor email you enter on this page.

What is the purpose of the program? What will members experience?

What is the age group and optimal group size?

What is the duration of the entire program? How many sessions? How long is each session?

What space, staffing, materials, equipment, etc., are needed?

How will participants benefit or what knowledge, attitudes or skills will they build as a result of participatin in this program

What will you collect data on or track to ensure the program worked? What will you use to gather the data?

Submit completed form to your supervisor for approval.