Cradle to Career Reporting Form: Mental Health-Related Events 2019-2020
The purpose of this form is to support our Cradle to Career goal of increasing the number of events (meetings, gatherings, planning sessions, etc.) where parents and youth have safe spaces to talk about mental health issues.
Full name (first & last):
Events include, but are not limited to, meetings, gatherings, and planning sessions.
What was the main mental health-related focus/topic/theme of this event?
One-time (not recurring)
Event start time:
Event end time:
Tompkins County town:
City of Ithaca
Town of Ithaca
Where did this event occur?
Please provide an address, building, and/or general location details.
Select all participant groups:
Children (birth to 6)
Children (elementary school)
Youth (middle school)
Youth (high school)
Youth (beyond high school)
Families (caregivers & children)
Number of participants (estimated):
Primary event purpose:
**The questions below are optional, but encouraged.**
What type of event evaluation was used?
How successful was this event?
Were there any significant insights, lessons learned, and/or other takeaways?
Any other comments/feedback?
Do you need any help or support for future events?
If yes, please provide a description of your current struggles and expectations/ideas for assistance.
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service