Verified Course - HUMAN-PROPELLED - Annual Report Survey

1.PROVIDER INFORMATION (required)
(Required.)

Course Provider

Verification Mark Number

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

2.RESPONDENT INFORMATION (required - contact for questions about survey responses)(Required.)

Name

Title

Email Address

Phone Number

3.REPORT PERIOD - CALENDAR YEAR
(Required.)

EXPLAIN if this is not a full year report

4.Summary Course Participation Data: In Question 5, you will upload a PDF copy of the Microsoft® Excel worksheet you completed on Course Participation Data for this Verified Course in the Human-Propelled domain. In this Question, please enter just the GRAND TOTALS for the following (numerical data only):

Courses Delivered

Students Enrolled

Children/Youth (≤ 17 yrs) Enrolled

Adults (18+ yrs) Enrolled

(Total) Certificates Awarded

Certificates Awarded to Students who Completed On-Water Instruction

Certified Instructors

5.Detailed Course Participation Data (PDF copy)

In Question 4, you provided summary data (select Grand Totals) for this Calendar Year. Now, upload a PDF copy of the Microsoft® Excel worksheet you completed on Course Participation Data. The Excel file should be emailed separately per the INSTRUCTIONS FOR REPORTING ANNUAL COURSE PARTICIPATION DATA AND PROGRAM FEEDBACK..

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