FSNE 4-H Program Evaluation Form

Project Time and Effort Form

Project
PersonID	(Any unique 3 - or 4 - digit number)
First Name
Last Name
Date of Activity	(mm/dd/yy)
Total Time Spent (in hours)
Time Spent in Direct Contact with Food Stamp Recipients (in hours)
Activities	* Please Specify details, such as "where", "to whom", "what lessons" in "Other Activities" below. When choosing multiple items, press ctrl + items
Other Activities

Note: This Time and Effort Form needs to be filled out with no more than one week delay.

------------------------------------------------------------------- Activities --------------------------------------------------------
Demonstration Preparation
Lesson Plan/ Workshop Development
Lesson Plan Review For Youth
Lesson Organization: Materials, Scripts and Props Gathering
Meeting -- With Community Agency Regarding Program Development
Meeting -- With Community Collaborators Regarding Certain Project*
Organization of Lesson Plans With Youth Worker
Presentation of Lessons*
Procurement Of Items For Lesson Delivery
Procurement Of Items For Food Demonstration
Program Nutrition Site Overseeing With Lessons, Food Demos, Youth And Supervisor Presentations
Reports Preparation And Processing
Phone Call Follow-up*
Youth Presensation Observation