PTPI Activity/Project Report
Thank you for all you do for your community and the world as a member of PTPI! Please submit project photos to after completing this form. PTPI may use photos and information contained in this report in promotional materials.
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Chapter/Member Name:
City and/or State:
Activity or Project or Name:
Date or Time Frame of the Activity or Project:
Activity or Project Summary:
Description, goals, beneficiaries, activities, outcomes, etc.)
Number of Members who Participated:
Number of Non-Members who Participated:
Number of Volunteer Hours Completed:
(per member, for time spent on preparation and implementation)
Number of Direct Beneficiaries Impacted by Activity or Project:
(event attendees, people affected, target audience, etc.)
Number of Indirect Beneficiaries Impacted by Activity or Project:
(wider community/individuals benefiting from project)
Total Number of Beneficiaries:
(direct plus indirect beneficiaries)
Did your Activity or Project Receive any Publicity? If So, Please Explain:
Do Students Under the Age of 18 Who Appear in Photos Submitted Give Consent to PTPI to Use the Photos?
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