Iowa State University Extension

Powerful Tools for Caregivers
 

 

Powerful Tools for Caregivers Iowa Class Leader Reporting

Please submit the following information following each class that you have taught. The information will be used only by the Iowa Powerful Tools for Caregivers program coordinator to track locations of programs, numbers of participants and participant responses. Summarized data will be available to Iowa class leaders. Thank you!

1. Class leaders: 

2. Class location:

3. Dates of class: 

4. Number of registered participants: 

5. Number completing at least 4 of the 6 sessions: 

6. Sponsoring organizations: 

7. Contributing organizations (in-kind, scholarships, financial support): 

8. Selected Results from class evaluation (found in Class Leader Tips notebook, page 187-188): 

As a result of this class do you believe you are a more confident caregiver than you were before taking the class?

# of responses collected
 # of "Yes" responses
 # of "No" responses

 

Did the class provide you with helpful information about community resources?

# of responses collected
 # of "Yes" responses
 # of "No" responses

 

Thank you for your help!

 
Last update: November 12, 2007
Contact: Kyle Kostelecky
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