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Fill and Sign the Claim Submittal Form

Fill and Sign the Claim Submittal Form

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APPENDIX 5 – Community How To Guide On...EVALUATION PARTICIPANT OBSERVATION FORM Meeting Observation 1. Who attended the meeting? Youth Parents Law Enforcement Alcohol Beverage Control Judicial System Educators Health/Prevention Specialists Public Officials Faith Community Leaders/Officials Business Owners Alcohol Retailers Other 2. Who participates in the meetings? 3. How are decisions made? 4. How is the leadership structure established? 5. How is the agenda established? 6. Are there members that are disruptive? If yes, how are they handled? 7. Are there specific accomplishments achieved by the end of the meeting? 8. How is the workload divided? 9. Is the meeting documented and materials sent to participants? x Underage Drinking Prevention Project YES NO Community How To Guide On...EVALUATION – APPENDIX 5 Participant Observation Form continued Contact Observation 1. Who is contacted? Youth Parents Law Enforcement Alcohol Beverage Control Judicial System Educators Health/Prevention Specialists Public Officials Faith Community Leaders/Officials Business Owners Alcohol Retailers Other 2. How is the contact made? YES NO 3. Who makes the contact? 4. What is discussed? 5. Is there follow up? Media Event Observation 1. What was the topic of the news event? 2. Where was the event held? Was it a good location? 3. Who were the speakers? 4. Was the event well organized? 5. What materials were distributed? 6. Were the materials appropriate, well written and newsworthy? 7. How was the media contacted? 8. What media attended? 9. Was it or was it not a successful event? Underage Drinking Prevention Project xi APPENDIX 5 – Community How To Guide On...EVALUATION Participant Observation Form continued Legislative Activity 1. Who supports the legislation? 2. What barriers were raised against the legislation? 3. Was the legislation modified? If yes, how? 4. Was an advocacy effort mounted for or against the legislation? If yes, was it effective? Why, why not? 5. Was the legislation passed? If yes, was there an effort to educate the public and/or youth about the legislation? Public Information/Education Campaign 1. What materials were included in the campaign? 2. Did the target audience(s) positively react to the campaign? If yes, why? If no, why? 3. Was there any media involvement in the campaign? Law Enforcement Activity 1. What was the activity? 2. Who was the target audience? 3. What occurred? 4. What was the reaction of the target population? 5. Were arrests/citations given? If yes, what was the number? 6. Was the activity/action successful? If yes, why? If no, why? 7. Did the media cover the enforcement action? 8. What was the disposition of the citations/tickets/arrests? Fines? Jail? License suspensions? Community service? Another sanction? xii Underage Drinking Prevention Project

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