Program Template

Program Template
Please note: this will be posted on the wiki so please do not include information you do not want available on the web
Table of ContentsProgram TemplateName of OrganizationName/Title of 1st Prevention ProgramMaterials/Curriculum/Campaign Used/AdaptedResources AvailableEvaluation EffortsFunding SourcesSamples of Materials/Exercises/ etcName/Title of 2nd Prevention ProgramMaterials/Curriculum/Campaign Used/AdaptedResources AvailableEvaluation EffortsFunding SourcesSamples of Materials/Exercises/ etc
Name of Organization

  • Organization address
  • Organization website
  • General contact email for organization
  • Contact telephone for organization
  • FAX:
  • TTY:

Description of the organization.

Name/Title of 1st Prevention Program

  • Program contact person’s name, job title
  • Program contact person’s information (email, telephone, etc)
  • Program website

Description of the prevention program.

Materials/Curriculum/Campaign Used/Adapted

Resources Available

  • Product A here: include description and how to obtain
  • Product B here: include description and how to obtain

Evaluation Efforts

Funding Sources

Samples of Materials/Exercises/ etc

  • Sample A
  • Sample B

Name/Title of 2nd Prevention Program

  • Program contact person’s name, job title
  • Program contact person’s information (email, telephone, etc)
  • Program website

Description of the prevention program.

Materials/Curriculum/Campaign Used/Adapted

Resources Available

  • Product A here: include description and how to obtain
  • Product B here: include description and how to obtain

Evaluation Efforts

Funding Sources

Samples of Materials/Exercises/ etc

  • Sample A
  • Sample B