Evaluate NBHAAD 2012

In an effort to ensure that activities and events occurring on February 7 are in direct line with the intentions and mission of NBHAAD, please take into consideration the following factors as you begin to plan. We hope that you will return after your activity and/or event is over to complete and submit this evaluation form.

   
Name of Organization:
Contact Person:
Title:
Address 1:
Address 2:
City:
State:
Zip Code:
Country (if not in USA):
Office Number:
Fax Number:
Email Address:
Website Address:
 
Please select the activities and/or events you put together for National Black HIV/AIDS Awareness Day 2012 and complete the corresponding questions:  
Did you collaborate with other community based organizations?
No Yes - how many other CBOs were involved?
 
Did you collaborate with the health department?
No Yes - how many health department workers participated?
 
Was your event a joint effort?
No Yes - how many groups worked together?
   
Art Competition How was it?
Excellent Good Fair Poor
   
Candlelight Vigil How was it?
Excellent Good Fair Poor
   
Community Forum How was it?
Excellent Good Fair Poor
   
Community Health Fair # of participants:
How was it?
Excellent Good Fair Poor

HIV Testing

# of persons tested:
# of persons receiving results:
# of persons tested POSITIVE:
# of persons referred for services:
How was it? Excellent Good Fair Poor
   
March/Rally How was it?
Excellent Good Fair Poor
   
Mayoral Proclamation Did you acquire a proclamation?
No
Yes - In order that we may archive the work of 2012, please email a copy to evaluation2012@blackaidsday.org.
   
Newspaper Article Was your event covered in the press?
No
Yes - In order that we may archive the work of 2012, please email a copy to evaluation2012@blackaidsday.org.
   
Press Conference Did you hold a press conference?
No
Yes - In order that we may archive the work of 2012, please make us a copy of the event and mail to: HBC | 964 Ralph David Abernathy, Suite C12| Atlanta, Georgia 30310-1833.
   
Public Service Announcement (PSA) Did you release a PSA?
No
Yes - In order that we may archive the work of 2012, please email a copy to evaluation2012@blackaidsday.org.
   
Radio Broadcast Did you have radio coverage or hold a broadcast?
No
Yes - please make us a copy of the broadcast and mail to: HBC | 964 Ralph David Abernathy, Suite C12 - Atlanta, Georgia 30310-1833.
   
TV/Cable Programming Did you have a program on TV or a local cable channel?
No
Yes - please make us a copy of the broadcast and mail to: HBC | 964 Ralph David Abernathy, Suite C12 - Atlanta, Georgia 30310-1833.
   
Voter Registration Did you register individuals to vote?
No
Yes - How many registered
   
Web Cast Did you hold a webcast?
No
Yes - please make us a copy of the webcast and mail to: HBC | 964 Ralph David Abernathy, Suite C12 - Atlanta, Georgia 30310-1833.
   
Other
(please specify):
   
Additional Comments: