TUPE Activity Log

Please describe below any Tobacco Use Prevention Education (TUPE) activities at your school site. A Summary report of all TUPE activities will be generated once you submit an activity. Feel free to submit a “test activity” (adding zero’s to all required answers) to view all submitted activities.

Email address *
Name: *
Your answer
School Year *
School District: *
School Name: *
Date TUPE Activity Was Held: *
MM
/
DD
/
YYYY
Number of Students Who Participated (Please provide number - give us your best estimate): *
Your answer
Participant Grade Level *
Required
Title/Name of the Event: *
Required
Brief Description of Event(s): *
Your answer
List the Name(s) of Clubs &/or Agencies Who Participated: *
Your answer
Learning Objective of the Event: *
Your answer
What materials were given at the event (select all that apply): *
Required
Click on the link that corresponds to your district and upload TUPE activity pictures in your school's folder. Thank you! *
What worked well regarding the planning and implementation of this/these activity(ies)? *
Your answer
How may the planning and implementation of this/these activity(ies) be improved in the future (please support the development of best practices) *
Your answer
Suggestions to improve this Activity Log:
Your answer
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