TUPE Activity Log
Please describe below any Tobacco Use Prevention Education (TUPE) activities at your school site.
Please submit one entry per activity.
NOTE: Incentives must be no more than $25 per student per year
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First and Last Name:
ACE School District
Campbell Union High School
East Side Union High School
Morgan Hill Unified
Palo Alto Unified
SCCOE Alternative Education
School Name (please no acronyms):
Date(s) TUPE Activity/Meeting Was Held:
What Activity(ies) Took Place?
Student Meeting - Peer Advocate(s)
Student Meeting - Other
Peer Advocate Panel
Social Media Campaign
Family Feud Game
Kick Off Video
Cups in a Fence
What's in a Vape Cloud
Dia de los Muertos
If other, please provide a brief description of the activity.
Was your activity held during any of the following?
Red Ribbon Week - October 23-31st
Dia de los Muertos - October 31-November 2
Black History Month - February
Take Down Tobacco Day - April
Earth Day - April 22
Foster Youth Month - May
LGBTQ PRIDE - June
Who led the activity?
TUPE Peer Advocates
Students Leaders (ex. ASB, Leadership)
TUPE Site Coordinator
Number of Students Who Participated in the Activity
Approximate is ok. If you did multiple activities, please add the total number of all the students who participated per activity from all the schools. This includes students reached by the activity.
Who was the audience?
What materials were given at the activity (select all that apply):
Swag (T-shirts, stickers, bracelets, etc.)
Educational Resources about Tobacco, Vaping, or Cannabis
What worked well regarding the planning and implementation of this activity?
How may the planning and implementation of this activity be improved in the future?
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Santa Clara County Office of Education.