Exit Flourish $aves STATS Form Question Title * 1. Student First & Last Name Question Title * 2. Date of Activity Question Title * 3. Sponsoring Organization of Activity Question Title * 4. Activity Title & Brief Description Question Title * 5. Hours Participated Question Title * 6. Supervising Adult's First & Last Name Question Title * 7. Supervisor's Phone Question Title * 8. Supervisor's Email Question Title * 9. How will you provide proof that you've completed this activity? (Note: We cannot make a deposit for this activity until we receive proof) I will drop off the signed STATS form to the FLOURISH office at DHS I will text a picture of the signed STATS form to 573-615-6137 I will email a picture of the signed STATS form to Angela.Sheffer@vu.com Other (please explain) Done
