Horizons Speakers Bureau Final Report
Project Director: Please complete this entire form and send it to us along with the copies of your completed
audience evaluation forms. The final report is due three weeks after the program date.
HSB Reference number: Click here to enter text.
Date of Program: Click here to enter a date.
Time: Click here to enter text.
Project Director: Click here to enter text.
Host Organization: Click here to enter text.
Program Location: Click here to enter text.
Program Title: Click here to enter text.
Speaker: Click here to enter text.
Total Attendance: Click here to enter text. If exact number is not available, please estimate.
Program Evaluation
Overall, I found the quality of this program to be:
☐ Excellent ☐ Very Good ☐ Average ☐ Disappointing ☐ Unsatisfactory
Did the speaker hold the audience’s attention 90% of the time?
☐ Yes ☐ No
What presentation methods did the speaker use? (Check all that apply)
☐ Lecture ☐ Performance ☐ Demonstration ☐ PowerPoint/Slideshow ☐ Q&A/Discussion
☐ Handouts ☐ Other________________
Were the presentation methods appropriate for the topic?
☐ Yes ☐ No
On a scale of 1 (lowest) to 5 (highest), how do you rate the speaker for:
Clarity: Choose an item.
Knowledge of the topic: Choose an item.
Ability to answer audience questions: Choose an item.
In order to help us serve your organization better, please answer the following questions:
How did your organization learn about the Horizons Speaker Bureau? (Check all that apply)
☐ Professional Organization ☐ Colleague ☐ NJCH Email ☐ H-NET ☐ Internet Search
☐ NJCH Website ☐ Social Media ☐ Other Email Click here to enter text. ☐ Other Click here to enter text.
Why does your organization participate in the Horizons Speakers Bureau? (Check all that apply)
☐ Quality of speakers ☐ Engaging topics ☐ Cost ☐ Convenience ☐ Ease of application process
☐ Other Click here to enter text.
How does the Horizons Speakers Bureau most impact your organization? (Check all that apply)
☐ Establishing relationships with scholars ☐ Helps you serve your existing audience
☐ Helps you create new audience ☐ Providing high-quality programming ☐ Other Click here to enter text.
In what other ways could NJCH help your organization accomplish its mission? (Check all that apply)
☐ Professional Development ☐ Grant Opportunities ☐ Organizational Development & Planning
☐ Reading & Discussion Series ☐ Film/TV & Discussion Series ☐ Lecture Series ☐ Traveling Exhibits
☐ Other__________________
Do you have any other comments, questions, or concerns?
Click here to enter text.
Survey Tabulation (Required)
Please enter the number of responses indicated for each question on the completed audience surveys.
1. Overall, I found the quality of this program to be:
Click here to enter text. Excellent
Click here to enter text. Very Good
Click here to enter text. Average
Click here to enter text. Disappointing
Click here to enter text. Unsatisfactory
2. Please tell us how you benefited from this program. (Check all that apply)
Click here to enter text. Learned something new about the topic
Click here to enter text. Engaged in a meaningful discussion
Click here to enter text. Reflected on the topic from a new perspective
Click here to enter text. Explored an issue of importance to my community
Click here to enter text. Inspired to learn more about the topic
Click here to enter text. Entertained by the program
Click here to enter text. Will influence other actions that I take in the future
Click here to enter text. Other
3. I plan to share ideas from this program with someone else.
Click here to enter text. Yes
Click here to enter text. No
4. Did you know about the New Jersey Council for the Humanities prior to attending?
Click here to enter text. Yes
Click here to enter text. No
5. How would you describe yourself
Age:
Click here to enter text. Child (<12)
Click here to enter text. Youth (12-18)
Click here to enter text. Adult (19-39)
Click here to enter text. Adult (40-64)
Click here to enter text. Senior (65+)
Ethnicity:
Click here to enter text. African American
Click here to enter text. Asian
Click here to enter text. Caucasian
Click here to enter text. Latin/Hispanic
Click here to enter text. Other
Gender:
Click here to enter text. Male
Click here to enter text. Female
Other:
Click here to enter text. Student
Click here to enter text. Educator
Click here to enter text. Veteran
Click here to enter text. Retired
Partner Contributions Report (Required)
ABOUT THIS FORM
This information is required by our principal funder, the National Endowment for the Humanities
(NEH), in order for NJCH to continue receiving federal funds to provide programming.
Please estimate the value of the time, services, and materials your organization spent, donated, or
received to host this program.
CATEGORIES
Staff Time
Volunteer time
Office Expenses
DESCRIPTION
COST/VALUE
(staff hourly rate) x (hours dedicated to coordinating and hosting Click here to
program)
enter text.
(volunteer hours) x (estimated hourly value of volunteer
Click here to
activities dedicated to coordinating and hosting program*)
enter text.
*see https://www.independentsector.org/volunteer_time
Click here to
Estimated value of office supplies, postage, printing, telephone
purchased or donated for program operation & activities
enter text.
Space
Rental cost of program space or the estimated value of rental
space used
Click here to
enter text.
Equipment
Rental cost of equipment used or the estimated rental value of
equipment donated
Click here to
enter text.
Food & Beverage
Cost or donated value of food and beverages for program
Click here to
enter text.
Promotion
Cost or donated value of printing and distribution of
promotional materials
Click here to
enter text.
Travel
Cost or donated value of any travel expenses associated with the
program
Click here to
enter text.
Other
Cost or donated value of any additional items not covered in
categories above
Click here to
enter text.
Provide a brief description Click here to enter text.
Click here to
enter text.
Provide a brief description Click here to enter text.
Click here to
enter text.
Total of all categories above
Click here to
enter text.
TOTAL
I certify that the foregoing information is true and correct.
_________________________________________________
Project Director Signature
Click here to enter a date.