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Tobacco Control Youth Board
YES Team Activity Report
(Please report for each activity)
Instructions:  Fill our the electronic report below.  Be sure to include as much as information as possible.  We will send you a confirmation of your submission via email.  The reports will be filed and sent to the UALR Evaluator.  If you have digital pictures, handouts, or any other electronic documents about your activity please email reports@yesteam.org on the SAME day that you submit your electronic report if at all possible.

If you have any question, please don't hesitate to call us at 501.375.1338 or toll free at 888-313-0388.  You can also email info@yesteam.org for assistance.

Thanks
YLI Staff
First Name
Last Name
Who led the activity (please include first and last name):
City
Zip Code
County:
Name of YES Team:
How many team members involved?:
Date of Activity:
Where did activity take place? City and County:
Describe the activity:
How many people reached by the activity? Please use as many different things as you can think of to show the impact of the activity:
Estimated # of people who saw a presentation, exhibit, or demonstration:
Number of handouts/giveaways that were passed out
Number of Comments (both negative and positive) that people made to team memers in response to the activity.:
Is there anything else you'd like to report about this activity and how it affected your team and community?:
How many new members did you recruit on the short forms?
YES Team E-mail Address (we will only send confirmations to yesteam.org email accounts):
Comments
The Tobacco Control Youth Board (TCYB), Team YES Speaks, and YES Team are all registered trademarks under the Youth Leadership Initiative and the Family Service Agency.
628 West Broadway, Suite 101, North Little Rock, AR 72114    888.313.0388   info@yesteam.org