ADA PREVENTION QUARTERLY REPORT
FORM 2: REPORTING TEMPLATE
* Required
Email address
*
Your email
Name of institution
*
The name of the reporting institution
Your answer
Category of institution
*
Ministry
State Department
State Corporation
Public University
Tertiary Institution
Commission
County Government
Other:
Reporting period
*
Quarter 1
Quarter 2
Quarter 3
Quarter 4
Contact Person
*
The name of the institution's ADA Control Committee Secretary or Point person
Your answer
Telephone number
*
The telephone number of the Contact person
Your answer
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