Urban Programs Post-Program Reporting Form 2016-2017
Please fill out this form for every program you direct. Please complete separate forms for each Summer program, Spring Break plunge or Dip you have.
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City *
In what city (or cities) did you have this program?
Name *
Please enter the name(s) of the program director(s)
Dates *
Use this format: mm/dd/yy - mm/dd/yy
Schools *
Which school(s) participated in the program?
Program Type *
What type of program was it? Dip: 1 - 3 days; Plunge: 4 - 10 days; Short program: 10 - 20 days; Summer program: 3 - 8 weeks; Year-round program: more than 2 months
Staff
InterVarsity Staff *
How many of your program staff were also InterVarsity Staff (including yourself)?
InterVarsity Volunteers *
How many of your program staff were official InterVarsity Volunteers?
Students
A breakdown of the student population who attended
Total Number of Students *
Total Number of Graduate Students *
Female Students *
Total number of female students
Male Students *
Total number of male students
Black/African American *
Total number of Black/African American students
Asian or Asian American *
Total number of Asian or Asian American students
Hispanic/Latino *
Total number of Hispanic/Latino students
Caucasian/White *
Total number of Caucasian/White students
Multi-ethnic *
Total number of Multi-ethnic students
Other Ethnicity *
Total number of students of an ethnicity not listed above
Other Ethnicity - Details *
Please list the ethnicity and number of students of an ethnicity not listed above
Non-believers *
Total number of non-believers
Skeptic to Seeker
Total number of students who, as a result of the program, moved from skeptic to seeker
Seeker to Follower
Total number of students who became followers as a result of the program
Students in Leadership *
Number of students in IVCF leadership or going into IVCF leadership on their campus
Partners
Please help us learn more about your partnering organizations
Number of Organizations/Churches *
Please list the number of organizations or churches you partnered with
Faith Based *
How many of your partnering organizations were faith-based?
Types of Activities/Ministries *
Check the types of activities/ministries or people groups your students engaged in with the partnering organizations
Required
Children or Vulnerable Adults *
To the best of your knowledge, how many children or vulnerable adults did you work with?
Students/Staff & Children or Vulnerable Adults *
To the best of your knowledge, how many of your staff/students worked with children or vulnerable adults?
Report Sexual Misconduct Training *
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