World AIDS Day 2001 Event Follow-Up Report

(Please evaluate any activity, no matter how small or large.) Please return your form by January 15, 2002.

Please complete and return this form if you or your organization observed World AIDS Day 2001. Your ideas, comments, photos and clippings will be used to improve future resource booklets and may be included in AAWH's Report of Activities.

Name ______________________________
Organization ______________________________
Street Address ______________________________
City ______________________________
State _____
Zip ____________

Phone ____________
Fax ____________
E-mail _______________________

1. Describe the event or activity you attended, participated in or organized. Please attach copies of materials from your event (especially photographs and newspaper clippings).

2. In what city was your event held? In what setting?

3. How did you publicize the event?

4. Is this your organization's first World AIDS Day event or activity? If not, did participation change from previous events or activities? Why?

5. Estimate the number of people who participated and attended. Describe the participants (adults, children, adolescents, young adults, staff members of a club/organization, etc.).

6. Did you find the book helpful and easy to use? Please comment.

7. What was/were the most useful and least useful part(s) of this resource booklet?

8. What can we change in next year's booklet to better help you plan for World AIDS Day 2002?

9. Put an "X" in the blank that best describes your receipt of the resource booklet.

Its arrival was:
______too early
______too late

I grant permission to AAWH to use the description of our activity and attached photographs in AAWH's AIDS Report and/or in the 2002 World AIDS Day Resource Booklet.

Name __________________
Title __________________
Date ______

Completed forms and attachments may be forwarded to:

American Association for World Health
1825 K Street, NW, Suite 1208
Washington, DC 20016
fax: (202) 466-5896