PLAN FOR DOCUMENTATION OF A PROJECT

OBJECTIVE:  (State the desired result of a specific project.  What is the aim of your action?  An overall program goal may
                                   include a number of specific projects, each with its own objective.)

                                                                                                                                                                                                                                 

                                                                                                                                                                                                                                 

                                                                                                                                                                                                                                 

                                                                                                                                                                                                                                 

TARGET POPULATION: (State the population directly affected by the program.  It could be a small group of people with
                                                             specified ages or an entire community.)

                                                                                                                                                                                                                                  

                                                                                                                                                                                                                                 

ASSUMPTIONS: (State basic beliefs or premises  which make it seem reasonable to proceed with this project.)

                                                                                                                                                                                                                                 

                                                                                                                                                                                                                                 

                                                                                                                                                                                                                                 

                                                                                                                                                                                                                                 

ACTION PLAN: (Schedule of activities for implementation of project objectives.  What steps will you take?

                                                                                                                                                                                                                                 

                                                                                                                                                                                                                                 

                                                                                                                                                                                                                                 

                                                                                                                                                                                                                                 

                                                                                                                                                                                                                                 

                                                                                                                                                                                                                                 

                                                                                                                                                                                                                                 

                                                                                                                                                                                                                                 

MEASURE OF OUTCOME: (List actions which will indicate achievement of the project objective.  How will you
                                                                   measure the success of your project?  What events or activities are planned to
                                                                   demonstrate accomplishment of objective?

                                                                                                                                                                                                                                 

                                                                                                                                                                                                                                 

                                                                                                                                                                                                                                 

                                                                                                                                                                                                                                  

Retain a copy for your club records.                                                                                                                                         JB/TG: 10/04

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