Brainerd Program Log
Each FYC/FebYC/RA/CA involved in a program must log their programs
Email address *
STAFF INFO
Staff Member Who Hosted Program: *
Program Co-Host(s):
Program Co-Host(s):
PROGRAM INFO
Program Name: *
Your answer
Residents Invited: *
(e.g., Stew 4, Hep 1, All of Stew, Star 5, Ridgeline Suites, Brooker & Prescott, etc.)
Your answer
Program Date: *
MM
/
DD
/
YYYY
Program Time: *
Time
:
Program Location: *
Your answer
Kind of Program: *
PROGRAM COST & SUPPLIES
Total Cost of Program: *
(If you didn't spend any money, just write 0)
Your answer
Items Purchased: *
(If you didn't buy anything, just write N/A)
Your answer
Vendor(s): *
(If you didn't spend any money, just write N/A)
Your answer
Funding Source: *
Purchase Method: *
Did you submit an itemized receipt & programming expense form to Kristy? *
(Be sure to complete the expense form and tape your itemized receipt to the page)
PROGRAM SUMMARY
Attendance: *
Your answer
What went well? What did residents enjoy? *
Your answer
What didn't work? What would you change? *
Your answer
What did your residents learn/gain? *
Your answer
Please share photos from the program with your CRD :)
A copy of your responses will be emailed to the address you provided.
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