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* 1. Name:

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* 2. Agency Visited:

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* 3. I have a better understanding of the agency’s mission and work after completing the site visit.

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* 4. I have a better understanding of the program's goals and impact after completing the site visit.

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* 5. The program demonstrates (or will demonstrate) measurable impact in the identified priority area.

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* 6. The program leadership is effective in communicating program goals and outcomes.

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* 7. Comments/Recommendations to the Community Impact Cabinet (including any action items):

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