LEAD & MANAGE MY SCHOOL
Using Existing Data in Your Needs Assessment

Worksheet 2- Contact Recording Form

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Worksheet 2: Contact Recording Form.rtf
Worksheet 2: Contact Recording Form.pdf

Here is an example of how a completed form might look:
Agency Name and Address:

Newton Middle School
65 Southwick Road
Newton, MA 02465

Staff Contact(s):

Name: Rose Adler (secretary) Phone number: (617) 847-9106
Name: Dave Dietrich (vice principal) Phone number: (617) 847-9106 x04

Indicator(s) of interest:

attendance records
suspensions
reported incidents of bullying and violence

Call 1 To Rose Date: 10/16/01

Summary:
Introduced myself and project. Explained what we were doing, what kind of information we needed, and what we were going to do with it. Rose suggested that I put everything in writing and send it to the vice principal (ccing herself and principal).

Follow-up steps:
Call vice principal to introduce myself, etc. Let him know that memo is on its way.

Call 2 To Dave Dietrich (vice principal) Date: 10/23/01

Summary:
He got memo, but hadn't read it. We went through it on the phone. He said it sounds good, but wants to set up a meeting with principal (and me) before he ok's release of anything. I volunteered to set up meeting -- otherwise afraid it might get lost in the shuffle.

Follow-up steps:
Call Rose to schedule meeting.

Call 3 Rose Date: 10/23/01

Summary:

Scheduled meeting for Monday, 10/27 at 10:15. She thought I'd get about 15 minutes.

Follow-up steps:
Come up with 3-4 reasons why school will benefit from sharing this info. Be prepared to let them know where else we're going for data.


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Last Modified: 11/19/2007