OMB Control Number: 0925-0648         Expiration Date: 5/31/2021

Thank you for all your work in organizing an event to support the Brother, You’re on My Mind (BYOMM) Initiative. Please complete the following assessment within 10 days of your event. Omega Psi Phi Fraternity, Inc.’s international headquarters will use the information to describe the types of activities that chapters are implementing.

* 1. Organizer Name:

* 2. Organizer Email:

* 3. Organizer Phone Number:

* 4. Chapter Name:

* 5. District:

* 6. Date of event (please enter in MM/DD/YYYY format):

* 7. Location (city, state) of community event:

* 8. Type of event:

* 9. How many participants attended this BYOMM event? (Please write a numeric entry or range)

* 10. Did you work with partners to plan or implement this BYOMM event?

25% of survey complete.