Five Star Chapter Excellence Program

University of Houston
EDUCATIONAL PROGRAM FORM
*Form is due 3 business days after the event.*

THIS FORM MUST BE TYPED.

*Note: Educational Programs include those hosted and/or sponsored by the chapter involving issues on health, wellness,
STD’s, eating disorders, relationships, drug and tobacco use, time management, etc.*

Semester (Fall/Spring): Year:

Council Affiliation:

Name of Greek Organization:

Name of sponsoring organization(s):

Program Coordinator:
Phone Number(s): UH Email Address:

Program Title/Topic:

Presenter Information:

Educational Program Form

Program Description/Purpose:

Day(s) and Date(s) of Program:

Time Program Began: Time Program Ended:

AUDIENCE
Audience (Please state the number in attendance in each category):

New Members Active Members Alumni/Guests

If a conference, please list the members from your chapter who attended: 11

Please attach the following when applicable:

*Copies of promotional materials *Copy of program evaluation sheet/results
*Handouts from program *Any additional material which may help document program
Educational Program Form, Page 1
For office use only
Date Submitted: Signature of Advisor:

Educational Program Form, Page 2