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:
Primary Contact Phone Number:
Secondary Contact(s) Name & Email: (Optional)
Name / Title of Activity:
Date of Activity:
Time of Activity:
Location of Activity:
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?
CCLO #1 - Leadership (Empower and Inspire Others, Navigate and Affect Change, Recognize Strengths, Work Toward a Shared Vision)
CCLO #2 - Inclusiveness (Promote cultural diversity within our community)
CCLO#3 - Social Responsibility and Service (Act with honesty and principle to facilitate positive social change)
CCLO #4 - Mindfulness (Identify effective self-care strategies to foster healthy, mind, body, and spirit; establish purpose, awareness and personal fulfillment; engage in reflection)
CCLO #5 - Lifelong and Global Learning (Demonstrate and apply interdisciplinary connections; cultivate a spirit of creative thought and curiosity to achieve goals)
Do you plan to assess/evaluate the event? Do you have access to Nuventive?
If available, send supporting documents for the activity (flyers, programs, pictures, etc.) to the email below:
Additional Comments or Questions:
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