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Member Information

Name of Member Program:

City:

State

Primary Contact:

E-mail:

Select week ending date for which you are reporting:

Number of stickers affixed to packages sent:

Number of postcards distributed:

Number of posters distributed:

Event if Applicable: (Past or Future)

Type

Location

Total Number of attendees at event:

Date

Audience/Description

Number of newsletters/emails sent:

Opening rate (if available):

Social Media (Add a response for each platform IF APPLICABLE)

Select Platform

Number of posts this week about the campaign:

Reach if known:

Number of followers:

Social media engagement (likes, retweets, comments):

Media interest/coverage:

Attach campaign-related photos where possible (i.e. arrival of materials, volunteers affixing stickers, distribution of materials, community interaction)

Comments:

Contact Information