DATE OF REPORT

NAME

AFFILIATION

DAYTIME PHONE

FAX

DATE OF WORKSHOP

TIME OF WORKSHOP

LOCATION OF WORKSHOP

ADDRESS

CITY

COUNTY

NAMES OF OTHER CERTIFIED WET LEADERS HELPING WITH WORKSHOP

TOTAL NUMBER OF PARTICIPANTS

AUDIENCE (LIST NUMBER THAT ATTENDED BESIDE CATEGORY)
EARLY CHILDHOOD TEACHERS

ELEMENTARY TEACHERS K-5

MIDDLE SCHOOL TEACHERS 6-8

SECONDARY TEACHERS

ADMINISTRATORS

WATER RESOURCE SPECIALIST

PRESERVICE TEACHERS/COLLEGE STUDENTS

COLLEGE FACULTY

NONFORMAL EDUCATORS
(YOUTH GROUP LEADER, PARK STAFF, OUTDOOR ED CENTER, ZOO, NATURE CENTER, MUSEUM)

GOVERNMENT AGENCY REPRESENTATIVE

OTHER

CHECK THE FOLLOWING AGENDA ITEMS THAT YOU INCORPORATED INTO YOUR PROGRAM.

WELCOME/INTRODUCTIONS
ICE BREAKER
WORKSHOP OBJECTIVES
PROJECT WET BACKGROUND
OVERVIEW OF GUIDE
LEADER-LED ACTIVITIES
PEER TEACHING
CURRICULUM CONNECTIONS
EVALUATION
OTHER

AUDIO/VISUAL EQUIPMENT USED

SPEAKERS PRESENTING

RESOURCE PERSONNEL ASSISTING

PROGRAM OVERVIEW

HOW DID THE PROGRAM GO
(PARTICIPANT RESPONSES, WHAT WORKED WELL, IDEAS FOR NEXT PROGRAM, ETC.)?

BUDGET INFORMATION/INKIND CONTRIBUTION
(EXAMPLE: YOUR TIME PREPARING, COPYING, SPEAKERS)

BUDGET INFORMATION/DIRECT EXPENSES

ACADEMIC OR OTHER CREDIT WAS PROVIDED: YES NO

IF YES, WHAT KIND:

HOW MANY UNITS:

FROM:

PARTICIPANTS INTERESTED:

NOTE: SEND CHECKLIST AND PAYMENT TO:
IDNR-PROJECT WET
5785 GLENN ROAD
INDIANAPOLIS, IN 46216-1066

MAKE CHECKS PAYABLE TO IASWCD
THANK YOU