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Ambassador Monthly Outreach & Activity Report
Ambassador Information
Organization / Agency / Training Institution
*
Ambassador Name
*
Email
*
Job Title
Month
*
Select Month...
January
February
March
April
May
June
July
August
September
October
November
December
Year
*
Select Year...
Outreach Activity 1
Activity Type
Select Your Outreach Activity Type...
Advisory Board Meeting
Director Meeting
Center Visit / Community Outreach
Conference
Email
Phone Call
Provider Meeting
Social Media Post
Website
Workshop
Other
Description if "Other"
Activity Date
If your outreach activity was providing technical assistance at several points over the month or a promotional share of T.E.A.C.H. on your organization’s website, please enter the
start
date of the activity here. (e.g., %date_month_first_day%)
Activity End Date
Please list the
end
date of the activity here, if applicable. (e.g., %date_month_last_day%)
Number of Participants
(e.g., estimated # of individuals)
Audience Reached
(e.g., teachers, directors, potential scholars)
Outreach Method
Select Outreach Method...
In-Person
Virtual
Materials Distributed
T.E.A.C.H. Scholarship Model Booklets (Eng/Spn)
T.E.A.C.H. Scholarship Program Sponsor Flyers (Director/FCCH)
T.E.A.C.H. Rack Cards (Credentials/Renewals/College Credit/Degrees)
T.E.A.C.H. Swag Items / Giveaways
(select all that apply)
Event Details
Note: Please use this field to provide any additional activity details information (e.g., Shared link to T.E.A.C.H. website or in monthly e-newsletter)
Outreach Activity 2
Activity Type
Select Your Outreach Activity Type...
Advisory Board Meeting
Director Meeting
Center Visit / Community Outreach
Conference
Email
Phone Call
Provider Meeting
Social Media Post
Website
Workshop
Other
Description if "Other"
Activity Date
If your outreach activity was providing technical assistance at several points over the month or a promotional share of T.E.A.C.H. on your organization’s website, please enter the
start
date of the activity here. (e.g., %date_month_first_day%)
Activity End Date
Please list the
end
date of the activity here, if applicable. (e.g., %date_month_last_day%)
Number of Participants
(e.g., estimated # of individuals)
Audience Reached
(e.g., teachers, directors, potential scholars)
Outreach Method
Select Outreach Method...
In-Person
Virtual
Materials Distributed
T.E.A.C.H. Scholarship Model Booklets (Eng/Spn)
T.E.A.C.H. Scholarship Program Sponsor Flyers (Director/FCCH)
T.E.A.C.H. Rack Cards (Credentials/Renewals/College Credit/Degrees)
T.E.A.C.H. Swag Items / Giveaways
(select all that apply)
Event Details
Note: Please use this field to provide any additional activity details information (e.g., Shared link to T.E.A.C.H. website or in monthly e-newsletter)
Outreach Activity 3
Activity Type
Select Your Outreach Activity Type...
Advisory Board Meeting
Director Meeting
Center Visit / Community Outreach
Conference
Email
Phone Call
Provider Meeting
Social Media Post
Website
Workshop
Other
Description if "Other"
Activity Date
If your outreach activity was providing technical assistance at several points over the month or a promotional share of T.E.A.C.H. on your organization’s website, please enter the
start
date of the activity here. (e.g., %date_month_first_day%)
Activity End Date
Please list the
end
date of the activity here, if applicable. (e.g., %date_month_last_day%)
Number of Participants
(e.g., estimated # of individuals)
Audience Reached
(e.g., teachers, directors, potential scholars)
Outreach Method
Select Outreach Method...
In-Person
Virtual
Materials Distributed
T.E.A.C.H. Scholarship Model Booklets (Eng/Spn)
T.E.A.C.H. Scholarship Program Sponsor Flyers (Director/FCCH)
T.E.A.C.H. Rack Cards (Credentials/Renewals/College Credit/Degrees)
T.E.A.C.H. Swag Items / Giveaways
(select all that apply)
Event Details
Note: Please use this field to provide any additional activity details information (e.g., Shared link to T.E.A.C.H. website or in monthly e-newsletter)
Outreach Activity 4
Activity Type
Select Your Outreach Activity Type...
Advisory Board Meeting
Director Meeting
Center Visit / Community Outreach
Conference
Email
Phone Call
Provider Meeting
Social Media Post
Website
Workshop
Other
Description if "Other"
Activity Date
Please list the
end
date of the activity here, if applicable. (e.g., %date_month_last_day%)
Activity End Date
Please list the end
date
of the activity here, if applicable. (e.g., %date_month_last_day%)
Number of Participants
(e.g., estimated # of individuals)
Audience Reached
(e.g., teachers, directors, potential scholars)
Outreach Method
Select Outreach Method...
In-Person
Virtual
Materials Distributed
T.E.A.C.H. Scholarship Model Booklets (Eng/Spn)
T.E.A.C.H. Scholarship Program Sponsor Flyers (Director/FCCH)
T.E.A.C.H. Rack Cards (Credentials/Renewals/College Credit/Degrees)
T.E.A.C.H. Swag Items / Giveaways
(select all that apply)
Event Details
Note: Please use this field to provide any additional activity details information (e.g., Shared link to T.E.A.C.H. website or in monthly e-newsletter)
No Activity
No Reported Outreach Activity
If you were unable to provide any T.E.A.C.H. outreach activity this month, please let us know and we can work together to increase access to potential scholars and sponsors in your area.
No Activity Details
Use this field to provide details or additional information (e.g., No activity for %date%. Our organization temporarily suspended in-person visits to local providers per health and safety.)
Submit