Program OTM Nomination Form

Month:

Category:

Person in Charge: Nominator:
Address: Address:
Phone: Phone:
Email Address: Email Address:
On-Campus Population
2900

Chapter Size
21

Program Title:
Target Population (in numbers):
 Time Needed to Organize:
Number of People in Attendance: Date(s) of Program:
Number of People Needed to Organize:
 Cost of Program:
Origin of Program (200 word max):
Please give a short description of program (400 word max):
Goals of program (200 word max):

Positive and lasting effects of the program (200 word max):
Short evaluation of the program (200 word max):
How could this program be adapted to other campuses (200 word max):