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Chapter/APS Name
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Report Submission Date:Please submit within 2 weeks after the event
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Event Date:
An approved proposal by the Executive Committee must precede its corresponding final report. Proposals will not be approved based on the final report.
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Chapter/APS President Name:
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Chapter/APS President Phone:
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Chapter/APS President Email:
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Chapter/APS President Address:
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Proposal Description
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SubjectDescriptionPost Event Outcome
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Self Report
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(to be completed after the Event)
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Event Title
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Event Date and LocationIf virtual, write "virtual"
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Event Goal Whether the proposed goal was met. Include participant feedback.
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(including Topic/Field of Focus)
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Detailed plan
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Expected number of participants Actual number of participants
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(types: R, G, UG, P)(types: R, G, UG, P) (types: R, G, UG, P)
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Expected number of renewing/new membersRenewed - R (10), UF (15); New - R (5), UG (3)
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(types: R, G, UG) (types: R, G, UG, P) (types: R, G, UG)
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Primary Speakers (if applicable)Actual speaker at the event
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Organizing Committee Chair and email
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Committee member names
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Budget
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SourceProposed AmountActual Amount Received
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KSEA support requested $ -
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External Support (including KUSCO and Local Fund Raising if applicable) requested $ -
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Total Amount $ -
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Itemized Expenses
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CategoryUnit CostQuantityTotal Amount EstimatedTotal Amount
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Actually Spent (Attach Receipts in Attachment 2)
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Food $ -
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Drink $ -
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Room Rental $ -
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Speaker Expense $ -
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Printing and Supplies $ -
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Other specifics (please specify) $ -
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Total Amount $ -
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