Orange County NC Website
Browse       Search
DocuSign Envelope ID:C096D0C4-21D1-4556-9576-77FCE44884E2 <br /> Attachment B <br /> Program Evaluation Form <br /> Program (circle): Summer Academic Program/Summer Recreation Program <br /> Start Date: <br /> Completion Date: <br /> Grade(s) of Participants: <br /> Average#of Participants per Week: <br /> Total Unique Participants: <br /> Was the fee waived for FSA enrolled families identified by the Health Department?Yes/ No <br /> Total Generated Revenue, not including Health Department funds: <br /> Total Program Expenses: <br /> Average Weekly Cost Per Participant: <br /> Program Supervised By (staff name): <br /> Program Review: Please share at least 5 bullet points on achievements of the summer program or <br /> recommendations for future consideration. <br /> • <br /> • <br /> • <br /> • <br /> • <br /> Evaluation Results: For the Summer Academic Program only, please attach any relevant evaluation data, <br /> including any pre-and post-test data. <br /> Expenses: For the Summer Recreation Program only, please attach a detailed accounting of expenses <br /> made to support participation of low-income and/or non-proficient students in the program. <br />