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Program Planning Form
156 High Street - Butterfields - 200 Church Street
Staff Member Last Name
Staff Member First Name
Date of Program
format: MM/DD/YYYY
Time of Program
Anticipated Program Location
Anticipated Program Presenter
Please write a brief description of this program?
What ResLife programming category does this fit into?
-- SELECT ONE --
Responsible
Inclusive
Learning
What Essential Capabilities will be addressed in this program?
-- SELECT ONE --
Writing
Speaking
Interpretation
Quantitative Reasoning
Logical Reasoning
Designing, Creating & Realizing
Ethical Reasoning
Intercultural Literacy
Information Literacy
Effective Citizenship
What type of program will this be?
-- SELECT ONE --
Social
Active
Passive
How do you plan to publicize for this event?
What are your expected expenses for this program and from what sources will you be seeking funding? Please itemize:
If this is a collaborative effort between staffs, please list the other staff members and their responsibilities:
If you work in a Program House, how does this program support the mission of your house?
