Challenge Report Back Form

REPORT BACK FORM Directions: We want to hear your results!! After you finished your 5 Challenge Projects, please complete this form and mail it back to us. Once we receive this form, we’ll be sure to recognize you for your great effort! Feel free to use additional paper or include attachments such as newspaper clippings, photos, etc. First Name:

Last Name:

Address: City:

State:

Phone Number:

School Name:

Birthday:

Email Address:

PROMISE

1

Caring Adults

Zip:

What project did you complete?






Absolutely Incredible Kid Day Big Brothers Big Sisters Family Volunteer Day Thank Your Mentor Day Other: ___________________________

How many people volunteered to help with this project? How many kids were provided with a Caring Adult as a result of this project?

Tell us about it! What was the most successful part of your project?

PROMISE

2

Safe Places

What would you change about your project if you were to do it again?

What project did you complete?






Lights On Afterschool Advocate for Play i-MENTOR Program Youth Traffic Saftey Month Other: ___________________________

What did you learn by completing this project?

How many people volunteered to help with this project? How many kids were provided with a Safe Place as a result of this project?

Tell us about it! What was the most successful part of your project?

What would you change about your project if you were to do it again?

What did you learn by completing this project?

REPORT BACK FORM, CONTINUED PROMISE

3

Healthy Start

What project did you complete?






March of Dimes WalkAmerica Host a Health Fair Positive Choice Program Prevent Teen Pregnancy Other: ___________________________

How many people volunteered to help with this project? How many kids were provided with a Healthy Start as a result of this project?

Tell us about it! What was the most successful part of your project?

PROMISE

4

Effective Education

What would you change about your project if you were to do it again?

What project did you complete?






Common Cents Groundhog Job Shadow Day Semester of Service Destination Imagination, Inc. Other: ___________________________

What did you learn by completing this project?

How many people volunteered to help with this project? How many kids were provided with an Effective Education as a result of this project?

Tell us about it! What was the most successful part of your project?

PROMISE

5

What would you change about your project if you were to do it again?

What project did you complete?

Opportunities
Global Youth Service Day to Help Others
Kids Care Clubs




Presidents Volunteer Service Awards Red Kettle Collections Other: ____________________________

What did you learn by completing this project?

How many people volunteered to help with this project? How many kids were provided with an Opportunity to Help Others as a result of this project?

Tell us about it! What was the most successful part of your project?

What would you change about your project if you were to do it again?

Once completed return this form either...

by mail:

What did you learn by completing this project?

by email:

America’s Promise Alliance [email protected] Attn: Katie Peters 909 N. Washington Street, Suite 400 Alexandria, VA 22314-1556

by fax: 703.535.3903