EmailMe Form - USWT State Visitation Report

USWT State Visitation Report

Please complete this form after making a State Visitation. Your observations can be an important part of servicing each state. Be thorough with your remarks. Submit within one (1) week of visit.

Use the File Upload field to include any supporting documents.

Responses to the online form will be viewed by the USWT President. Fill in as much information as you know. Upon completion of the form, click Submit; you will receive a confirmation screen if your form has been successfully submitted. (rev 2017)

Your Email *
Name *
First Last
Date of Visit *
MM / DD / YYYY
Position *
State Organization Visited *
Other State Organization Visited *
If your state is not listed, please enter your state.
Visit Purpose *
Describe the purpose of your visit (speaker, training, extension, etc.)
Evaluate Visit *
Explain how you achieved your purpose?
Evaluate Event *
Explain how well the event was planned
What were your impressions/reactions of the leaders & participants? *
Enter "none" if there is nothing to report
Follow-Up Suggestions *
Explain the follow-up that is suggested/necessary; if there are individuals who would benefit from a call or note, please include their name and address/phone number; enter "none" if there is nothing to report
List any other comments, questions or concerns you may have. *
Enter "none" if there is nothing to report
File Upload

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