DATE OF EVENT __________________________
TITLE OF EVENT_________________________________________
4 C Category _______________
SPONSORING AGENCY _______________________________________________________________
LEARNING OUTCOMES:
WHAT SPECIFIC ACTIVITIES HELPED YOU ATTAIN THE LEARNING OUTCOMES?
HOW WILL YOU APPLY WHAT YOU LEARNED TO YOUR OWN LIFE AND/OR MINISTRY?
OVERALL RATING: 1 2 3 4 5
ADDITIONAL COMMENTS:
_________________________________
(Signature)Revised 4/17/06