Professional Development & Outreach Activity Report

Please Complete & Submit Within ONE DAY of Activity
1. NAME OF ACTIVITY:
2. TYPE OF ACTIVITY:
3. TOPIC OF ACTIVITY:
4. DATE(S) OF ACTIVITY:
MM DD YYYY
Start Date
/
/
End Date
/
/
5. LENGTH OF ACTIVITY:
Hours
Day 1
Day 2
Day 3
Day 4 & over
6. LEVEL OF ACTIVITY:
7. WHAT HANDS-ON SOFTWARE OR HARDWARE DID THE ACTIVITY INCLUDE?(Please check all that apply)
8. LOCATION OF ACTIVITY:
9. GEOGRAPHIC COORDINATES OF ACTIVITY (see below):
WEB SITE FOR FINDING GEOGRAPHIC COORDINATES: (copy & paste into your web browser)
http://edcommunity.esri.com/maps/index.cfm#
10. CONTACT INFORMATION FOR ACTIVITY AT INSTITUTION OR CONFERENCE:
11. TIER/CONTACT INFORMATION FOR ACTIVITY AT GEOTECH CENTER:
12. ACTIVITY FUNDED BY:
Percent Funding
National Geospatial Technology Center (GeoTech Center)
Sponsoring Institution
Co-sponsor(s)
13. NUMBER OF PARTICIPANTS ATTENDING THE ACTIVITY OR IMPACTED BY THE EVENT:
StudentsAdult LearnersTeachers/EducatorsAdministrators
Primary School:
Middle School:
High School:
Two Year College:
University (4 year):
Other:
14. OUTCOME OF ACTIVITY (check all that apply):
15. FUNDING INCREASE DUE TO ACTIVITY:
16. YOUR CONTACT INFORMATION (person completing this form)
THANK YOU.

Phil Davis
pdavis@delmar.edu
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