Submit an Activity Program, Campaign or Intervention (form)

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Human Kinetics / Community Centers / Active Aging Community Center / Programs / Submit an Activity Program, Campaign or Intervention (form)

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	Submit an Activity Program, Campaign or Intervention (form)

Submit an Activity Program, Campaign, or Intervention
How to use this form: To report an activity program, campaign, or intervention that is relevant to researchers or practitioners in the active aging field, please complete this form. When describing the program, please do not copy information directly from another source. Use your own words. Please complete all information below.


Your name:
Your name:
Your job title:
Your job title:
Your organization:
Your organization:
Your e-mail address:
Your e-mail address:
Your city, state, country:
Your city, state, country:
Name of program:
Name of program:
Organization:
Organization:
Location (city, state, country):
Location (city, state, country):
What is the program? Be sure to describe what it is, the major components, how the program is run, who participates, and why. (maximum 250 words)
What is the program? Be sure to describe what it is, the major components, how the program is run, who participates, and why. (maximum 250 words)
Why is the program successful? (maximum 50 words)
Why is the program successful? (maximum 50 words)
Link to official Web site:
Link to official Web site:

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