TMC Lab Usage Report

1. Lab Number/Hosting Organization*

Select

2. Name of your organization*

3. Report filed by:*

Your name here

4. Email*

5. Date of use

If multiple sessions, indicate first date of use for this user report

6. Number of Sessions*

How many times was TMC used during this time?

7. Total number of hours*

How many "program hours" were delivered using TMC?

8. Number of youth participants*

For this session or during this reporting period

9. How many youth were first-time participants?*

For this session or during this reporting period

Select

10. Community Served*

Name of town/community

11. Program name and/or location*

Name of youth program, class, library, community center, park, etc.

12. School name, if applicable*

Type N/A if lab was not used at a school (i.e. Lab was used at a community center, library, etc.)

13. School District and Number, if applicable

14. In-school or out-of-school use*

Was the lab used at a school or elsewhere? Was the lab used during school hours or non-school time?

Select or enter value

15. How was the lab used?*

Select or enter value

16. Number of staff, volunteers and/or teachers who used the lab*

During this report period

18. Other activities used

TMC or non-TMC activities

19. Youth Feedback*

Generally, how was the TMC Lab received by youth?

Select or enter value

20. How well did the activities work?*

Did staff feel that sessions were both "hands-on" and "minds-on?"

Select

21. Highlights and stories*

How did it go? What did the kids say about the lab? What worked best?

22. Community Engagement

How did non-staff adults or teachers engage in using the lab?

23. Comments or Suggestions for Improvement

How can we learn from your experience using the lab?

Demographic Information

Answer to the best of your ability, using visual estimation if necessary.

These options are based on the U.S. federal demographic terminology.

Gender

Male

%

Female

%

Gender unknown

You can chose this option to include non-binary and other genders.

%

Gender data not reported or collected

Ethnicity

Hispanic or Latino

%

Not Hispanic or Latino

%

Ethnicity unknown

%

Race/ethnicity data not reported or collected

Race

American Indian or Alaska Native

%

Asian

%

Black or African American

%

Native Hawaiian or Other Pacific Islander

%

White

%

Race/ethnicity unknown

%

Race data not reported/collected

Restocking Report

If your TMC program leader requires it, fill out this section completely at the end of each day or activity.

This section will be used by your organization to order and restock materials. The Idaho Out-of-School Network does not require this information.

Materials Used

List specific materials used and quantity.

Which materials need to be restocked?

Any Issues?

Did anything break? Do we need to replace anything? Did anything not work the way it's supposed to?

Send me a copy of my responses