Form Event Description Event Description Event Description Form

Technology Transfer Center (TTC) Program Monitoring

Attachment 1_TTC Event Description Form

Event Description Form

OMB: 0930-0383

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Event Code ________________

TTC Event Description Form


Please complete this form for each event implemented or sponsored by your TTC.


Date: ___________________ Location: ________________ TTC: ____________________


Event Title: _____________ ______________ Event Code No.: ___________________



Total # of participants: ________


# of participants consenting to follow-up: _________ Total # of Follow-up surveys sent: _____


Enter N/A for “Not applicable” if the event is less than three hours.



How many contact hours is this event? __________



For international TTCs ONLY:


Is this a PEPFAR qualifying event? ____YES ____NO



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File Typeapplication/msword
File TitleEducation and Training Event Description Form
AuthorLisa M. Reboy-Woolery
Last Modified BySYSTEM
File Modified2018-12-18
File Created2018-12-18

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