SSU Library Outreach
This form is to collect data on library outreach programs & events (internal use only).

     ◘ Do not include programs exclusively for Library personnel or student employees  
     ◘ Do not include exhibits. However, you should include programs related to exhibits
     ◘ Do not include stats for New Student Orientations, which will be recorded separately
     ◘ Do not include programs connected to a specific course, please fill out the library instruction
        reporting form instead: tinyurl.com/y7vrstta 

*Note: Please fill out form for each (non-consecutive) outreach session, regardless of whether this event or program is part of an ongoing series (for example, fill out a separate form for each iteration of Pan y Cafe, but only fill out one form for a multi-day event like the Pop-Up Tea Library).

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Name *
Additional Organizers (if co-led)
Name of Program *
Co-Sponsors & Collaborators
Name any outside organizations that partnered in the program
Start of Program *
MM
/
DD
/
YYYY
Time
:
How long was the program? *
Please record in number of MINUTES and across days if a multi-day event
Program Frequency *
Program Setting *
If location is not listed, choose other and enter the setting below.
Program Setting: Other
If location is not listed, please enter it here
Program Type *
Primarily, what type of program or event was this?
Required
Program Purpose (check all that apply) *
Identify the primary objective(s) and goal(s) for the event.
Required
Attendance *
How many people participated or were present at the event?
Attendance Type (check all that apply)
Comments or notes (optional)
Submit
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