WORKNOW Pop-Up Wrap-Up Accountability Form

Date of Event *

First and Last Name *

(Pop-up hosts)

Phone *

Email *

Name of CORE Partner Organization/s Represented *

Where did you offer outreach and recruitment today? (Event Title) *

(Please add the event title)

Day of the Week and Time of Day? *

In what Zip Code did you offer outreach? *

About how many people were exposed to WORKNOW at this event? *

How many people completed the WORKNOW Interest Forms or signed the Sign-In sheet? *

Were there any common questions repeatedly asked by community members? If so, what were they?

Did you know the answers to these questions? *

Yes

Would you recommend WORKNOW be represented at this event/location in the future? *

Yes

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