Co-Curricular Activity Proposal & Reporting Form
Please complete the pre-planning form below. Student Co-Curricular Activities are broad in both style and definition. In order for UAPTC to maintain its designation as a premier institution for higher learning, it is essential this information be captured.

The purpose of the form is to provide:

1) common considerations when planning your activity,
2) appropriate communication of need & support across departments,
3) documentation & reporitng of your activity,
4) assessment and evaluation of activities and events,
5) alignment of activities to UAPTC Co-Curricular Learning Outcomes.
Primary Contact Name: *
Your answer
Primary Contact Phone Number: *
Your answer
Secondary Contact(s) Name & Email: (Optional)
Your answer
UAPTC Affiliation: *
Name / Title of Activity: *
Your answer
Activity Description: *
Your answer
Date of Activity: *
Time of Activity: *
Location of Activity: *
Your answer
Activity Location
If your activity requires reservation of a UAPTC facility, please also complete the facility request form:
Which co-curricular learning outcome(s) align with your activity? *
Do you plan to assess/evaluate the event? Do you have access to Nuventive?
Your answer
If available, send supporting documents for the activity (flyers, programs, pictures, etc.) to the email below:
Additional Comments or Questions:
Your answer
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