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An Evaluation of the Violence is Preventable (VIP) Program

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Partner School #3:<br />

Please tick one:<br />

New School<br />

<strong>VIP</strong> School from 2007-2008 school year<br />

Name <strong>of</strong> School:<br />

__________________________________________________________________________<br />

Mailing Address: ________________________________ City: _______________ Postal Code:<br />

__________<br />

Phone: ____________________ Fax: _______________<br />

*Contact Person(s): ______________________________________ Email:<br />

____________________________<br />

Type <strong>of</strong> <strong>VIP</strong> Service implemented (please tick all that apply): ____ Awareness ____ Classroom ____<br />

Group<br />

Partner School # 4:<br />

Please tick one:<br />

New School<br />

<strong>VIP</strong> School from 2007-2008 School Year<br />

Name <strong>of</strong> School:<br />

__________________________________________________________________________<br />

Mailing Address: ________________________________ City: _______________ Postal Code:<br />

__________<br />

Phone: ____________________ Fax: _______________<br />

* Contact Person(s): ______________________________________ Email:<br />

____________________________<br />

Type <strong>of</strong> <strong>VIP</strong> Service implemented (please tick all that apply): ____ Awareness ____ Classroom ____<br />

Group<br />

55 | F a l l 2 0 0 8 V I P E v a l u a t i o n

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