GEAR UP Event Scheduling: 2014-2022

Please note that you must have written approval in ADVANCE from your Program Director in order to host any GEAR UP event. Please complete the following form at least two weeks prior to your event. Your Program Director will contact you via email regarding approval or requests for further clarification.

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* 1. Name of Event:

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* 2. Which work plan requirement does this activity fulfill?

In-state college bus tour

In-state job site visit

College application and exploration week event

Transition to college event

College and career planning workshop (students and families)

FAFSA completion workshop

College Decision Day event

Text 4 Success Opt-In Event

Other and joint events (i.e. college visit with job site visit):

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* 3. School:

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* 4. Please provide a brief (50 words or less) description of your event:

The description you provide in the above field will be used to describe your event on the WV GEAR UP web site. It will also provide GEAR UP regional and central staff with a better understanding (and record) of your activity.

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* 5. Date and Time of Event:

Start:

Date

Time

AM/PM

End:

Date

Time

AM/PM

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* 6. Event location address:

School/Organization: *

Street address: *

Address 2:

City/Town: *

State: *

ZIP: *

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* 7. Specific location details (e.g. building, room #, etc.):

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* 8. Event Coordinator:

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* 9. Site Coordinator (if different than Event Coordinator):

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* 10. Target Grade Level (check all that apply):

7th

8th

9th

10th

11th

12th

Postsecondary

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* 11. Event Category:

Other (please specify)

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* 12. Are any GEAR UP funds being used to pay for this event?

comments or notes:

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* 13. Target Audience (Check all that apply):

Students

Family

Educators

Community Members

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* 14. Which of the four GEAR UP objectives does this activity meet? Check all that apply:

Increase academic performance and preparation for postsecondary education among GEAR UP students.

Increase the rate of high school graduation and participation in postsecondary education for GEAR UP students.

Increase the educational expectations, preparation and knowledge of postsecondary options and financing for GEAR UP students and their families.

Enhance GEAR UP educators' knowledge to improve student achievement and success in postsecondary education.

Provide additional details here, if necessary.

Note: If your event does not meet at least one of the goals listed above, then the event cannot be counted as a GEAR UP activity.

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* 15. Describe any plans for promotional/incentive activities or giveaways:

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* 16. Will you be soliciting/accepting donations for this event?

If yes, please describe

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* 17. Additional Notes (guest speakers, partnering with other events, etc.):

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* 18. Send a copy of this form to my Program Director:

Elizabeth Manuel (Southwestern Region)

JR Luyster (Central Region)

Questions about this form? Please contact your program director: www.wvgearup.org/contact-us/.