NAME:_____________________________ GRADE:__________SCHOOL:____________________

DISTANCE LEARNING FOLLOW-UP FORM

Please complete this form after your distance learning activity and send Carol Sweeny. Keep a copy for your records.

Activity #2

Please provide a brief description of the distance learning activity you organized:

SENDING: (another organization calls you and you present to this organization or school)

Title of Presentation:

Organization you presented to:

Date:

Describe Activity: (two or three sentences is sufficient)