Dream It, Be It Reporting Form

Dream It, Be It Reporting Form
Thank you for hosting a Dream It, Be It project in your local community!

Before beginning, please review the Dream It, Be It Club Reporting & Evaluation Worksheet for tips on how to best complete this form.

You will be asked to report currency in $US. Please use this calculator to find your currency's equivalent in US before you start the report.
If you have photos and/or videos to share of your project, you will be asked to provide everyone's name and media consent form.

**Please be sure to collect a media consent form from all individuals in the photo or video.**

Click here to download the PDF media consent form to attach it to this form.
Tips for saving your form:

There is no need to save the report as you go unless you are going to finish it at a later time. If you do need to save the report, please click the downward triangle next to "How to Save Your Form" at the bottom of each page. Please follow the instructions.

To save and return to this reporting form at a later time, click "Save."
You will be prompted to create an account on the online platform which hosts this form, JotForm.

Creating an account is not necessary! Instead, click "Save" then click the text at the bottom of that box in blue which reads "Skip Create an Account."

Please type your email and a link will be sent to you with all of your information saved or you can copy the link and save it somewhere to access it later.

Questions? Please email program@soroptimist.org or call 215-893-9000 ext. 113 or 156.

Project Information
Is this a Region or Club project?
Name of Organization:
Soroptimist Region:
America del Sur Region: Reporting Club Name
Brazil Region: Reporting Club Name
Camino Real Region: Reporting Club Name
Camino Real Region
Central East Coast Region: Reporting Club Name
Central East Coast Region
Desert Coast Region: Reporting Club Name
Desert Coast Region
Eastern Canada Region: Reporting Club Name
Eastern Canada Region
Founder Region: Reporting Club Name
Founder Region
Golden West Region: Reporting Club Name
Golden West Region
Japan Chuo Region: Reporting Club Name
Japan Chuo Region
Japan Higashi Region: Reporting Club Name
Japan Higashi Region
Japan Kita Region: Reporting Club Name
Japan Kita Region
Japan Minami Region: Reporting Club Name
Japan Minami Region
Japan Nishi Region: Reporting Club Name
Japan Nishi Region
Korea Region - Reporting Club Name
Korea Region
Mexico/Centroamerica Region: Reporting Club Name
Mexico/Centroamerica Region
Midwestern Region: Reporting Club Name
Midwestern Region
North Atlantic Region: Reporting Club Name
North Atlantic Region
Northwestern Region: Reporting Club Name
Northwestern Region
Peaks to Plains Region: Reporting Club Name
Peaks to Plains Region
Philippines Region: Reporting Club Name
Philippines Region
Sierra Nevada Region: Reporting Club Name
Sierra Nevada Region
Sierra Pacific Region: Reporting Club Name
Sierra Pacific Region
South Central Region Reporting Club Name
South Central Region
Southern Region: Reporting Club Name
Southern Region
Taiwan Region: Reporting Club Name
Taiwan Region
Western Canada Region: Reporting Club Name
Western Canada Region
SIAHQ : Reporting Club Name
SIAHQ
Reporting Club/Region/Partner (hidden - staff only)
Reporting Club Name:
Reporting Club Number:
Did you share equal management of this Dream It, Be It project with any other clubs?
Reminder:

If another club shared equal management of the project, provide the club name and number below → Submit only ONE report

If another club helped but did not share equal management → Select “No” and list them as a Supporting Club in the next question.

Do not report the same club as both.
After entering the Club's Name and Club Number, please click "Save."

You can continue adding Clubs by clicking "Save."

You can edit or delete these entries using the icons to the right of the entry.
Please enter the Club's Name and Club Number.
Not sure of the club's number? Search for it by typing the club's name below. . (OPTIONAL – If you already know the name and number of the club, please disregard this table. This is only for reference.)
Did any other clubs support this Dream It, Be It project through financial support, in-kind donations, providing speakers, or administrative support, and/or providing additional opportunities for girls?
After entering the Supporting Club's Name and Supporting Club Number, please click "Save."

You can continue adding Supporting Clubs by clicking "Save."

You can edit or delete these entries using the icons to the right of the entry.

Not sure of the club's number? Look it up by typing the club's name in the table above. (If you already know the name and number of the supporting club, please type it below.)
Please enter the Supporting Club's Name and Supporting Club Number.
Reported By:
Name:

First NameLast Name
Email:
example@example.com
Phone Number:
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  Please type your email and a link will be sent to you with all of your information saved or you can copy the link and save it somewhere to access it later.

Project Details
When did you host your Dream It, Be It project?

MonthDayYear
Date of first conference or session.
This date is during the previous club year. The deadline for reporting last club year's projects was June 30. This project cannot be counted for the current club year.

Please reach out to sarahd@soroptimist.org with any questions.

If you put this date in error, please change the date above to continue.
Please list all other dates:
How many girls participated?
How many volunteer hours did your club(s)/organization commit?
How many members were directly involved in delivering the project (interacting with girls, providing mentoring, etc.)?
How many members were part of the planning process for the project?
How much money did your club(s)/organization expend?
Please report currency in $US. Please use this calculator to find your currency's equivalent in USD$.
Our project:
How many new members did your project attract?
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How many girls in total received additional support?

Please provide the number of girls who participated in each opportunity:

Rows	Number of Girls
College visits
Workplace visits
Connecting girls with women in careers of interest
Job shadow days
Internships
informational interviews
Volunteer opportunities

Other:
Please describe 'Other':
Did your project provide any additional support opportunities (such as college visits, internships, job shadowing, etc)?
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Participant Demographics
What were the ages of the participants? (select all that apply)
Did you use the curriculum with a project for adults?
Please describe your project and the populations that it served.
Does your club have any demographic information about your participants (such as coming from low-income family, single parent household, being pregnant or parenting)?
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  Creating an account is not necessary! Instead, click "Save" then click the text at the bottom of that box in blue which reads "Skip Create an Account."
  
  Please type your email and a link will be sent to you with all of your information saved or you can copy the link and save it somewhere to access it later.

To the best of your knowledge, do the majority of your Dream It, Be It participants experience the following situations:

Please select one of the following responses from the dropdown menu: Yes, No, I don't know
Majority of participants come from a low-income family.
Majority of participants come from a single-parent household.
Majority of participants are in foster or alternative care (not living with their biological parents).
Majority of participants are pregnant or parenting.
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Girl’s Evaluation Form
Did your club provide this Evaluation Form to your participants and collect the results?
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  Please type your email and a link will be sent to you with all of your information saved or you can copy the link and save it somewhere to access it later.

Girl’s Evaluation Information
How many participants submitted an Evaluation Form?
Please read the following statements and report the TOTAL number of participants who selected each response.
As a result of participating in Dream It, Be It...

Please type the number of girls who selected each response. If no one selected that response, please type "0."

Rows	Strongly Agree	Agree	Uncertain	Disagree	Strongly Disagree
I feel more confident about my future success.
I feel more prepared to pursue my career goals.
I have new tools to overcome obstacles to my success.
I have new tools to overcome setbacks.
I understand how my values can connect to possible careers.
I know women who want to support my professional aspirations.
I was introduced to professional role models.
I had an opportunity to create achievable goals for my future.

- To save and return to this reporting form at a later time, click "Save."
  
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  Creating an account is not necessary! Instead, click "Save" then click the text at the bottom of that box in blue which reads "Skip Create an Account."
  
  Please type your email and a link will be sent to you with all of your information saved or you can copy the link and save it somewhere to access it later.

Girl’s Evaluation Information
Please enter the number of participants who completed the following questions:
What do you see as the number one obstacle to your career success?
Number of participants who were able to identify at least one obstacle to career success:
Number of participants who were NOT able to identify at least one obstacle to career success:
Did you learn strategies to overcome that obstacle?
Number of participants who responded "Yes" (to having learned strategies):
Number of participants who responded "No" (did not learn strategies):
What are two things you can do to recover from a setback to achieving your goals?
Number of participants who were able to identify at least two things to recover from a setback:
Number of participants who were NOT able to identify at least two things to recover from a setback:
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  Please type your email and a link will be sent to you with all of your information saved or you can copy the link and save it somewhere to access it later.

Girl’s Evaluation Information

Please categorize the short answer responses that participants gave to the question: "What was your favorite part of Dream It, Be It?" based on the options below.

Rows	Please enter the number of times each response was mentioned in the short answer responses.
Meeting new friends and being able to share thoughts and ideas with other girls:
Meeting inspirational women who can serve as mentors and role models:
Learning new skills I can use in everyday life:
Learning about various career opportunities and resources available to me:
Feeling inspired to dream about my future:

Something else that doesn’t apply to the options listed above.
Number of times this response was mentioned in the short answer responses.
'Something else' - please summarize their responses.
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Please categorize the short answer responses that participants gave to the question: "How can we improve this program for other girls?" based on the options below.

Rows	Please enter the number of times each response was mentioned in the short answer responses.
They want more information about resources for their education and career.
They want more interaction with mentors.
They want more activities or sessions.
They want more time for conversations and thinking.
They want more guest speakers discussing their careers and obstacles.

They want something else that doesn’t apply to the options listed above:
Number of times this response was mentioned.
If girls said something else, please summarize their responses:
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What additional support do you need to live your dreams?

Rows	Please enter the number of times each response was selected.
More mentoring opportunities
Online mentoring
An online group of girls who have completed Dream It, Be It
An opportunity for funding to support education or career training

Other:
Number of times this response was selected.
Please summarize responses for participants who selected 'Other':
Did any girls indicate (Question 15 on evaluation form) that Soroptimist may quote their responses?
Please share stories or quotes from your Dream It, Be It project with SIA!
These stories and quotes may be highlighted through SIA communication channels such as Facebook, Best for Women, LiveYourDream.org, etc.
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Participant Contact Information
Did any participants indicate that Soroptimist may follow up with them in the future?
Are they over the age of 13?
We are not collecting any contact information for any participants under the age of 13.

Please do not submit their contact information if you are not sure.
Please check the box below, if...
Instructions:

After entering the Participant's Name and Email Address below, please click "Save."
You can continue adding Participants by clicking "Save."

You can edit or delete these entries using the icons to the right of the entry.

Please do not provide the contact information for anyone under 13 years old.
Please provide the participant's name, email address, and age. If you are not sure if they are over 13 years old, please do not provide their contact information.
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  Creating an account is not necessary! Instead, click "Save" then click the text at the bottom of that box in blue which reads "Skip Create an Account."
  
  Please type your email and a link will be sent to you with all of your information saved or you can copy the link and save it somewhere to access it later.

Was your Dream It, Be It project extraordinary? If your club went above and beyond the use of the curriculum, please tell us how!
If your club gained new members from this project, we’d love to hear the story! Please describe how this person heard about Dream It, Be It/Soroptimist and why they made the commitment to join!
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  Creating an account is not necessary! Instead, click "Save" then click the text at the bottom of that box in blue which reads "Skip Create an Account."
  
  Please type your email and a link will be sent to you with all of your information saved or you can copy the link and save it somewhere to access it later.

Does your club have photos and/or videos to share from your project, AND have media consent forms for the individuals in the photographs?
By uploading photographs and/or video and clicking submit, I agree to the below terms and conditions.
Note: These pictures may be highlighted through SIA communication channels such as social media, Best for Women, LiveYourDream.org, etc. Please make sure that you have media consent from each person before sharing the photo.

Photos are not required.
By uploading photographs and/or video and clicking submit, I agree to the below terms and conditions.
If you do not have consent to sharing these photographs and/or videos, please change your answer to "No.”

Click here to download the PDF media consent form to upload it to this form.
Please upload your media consent form(s) here:

Cancelof
What would you like to share?
Upload your photographs and/or video files here:

Cancelof
Please list the names of everyone in the photos:
If we do not have all the names and media consent for each person, we will not be able to use the photo(s) and/or video(s).
Please include link(s) to the video(s) below. (Please list names of all people in the video under the link.)
(YouTube, Dropbox, Vimeo, etc.)
Please let us know if you only have a video file and need assistance sharing it.

You can reach us at program@soroptimist.org or 215-893-9000 ext. 113 or 156.
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  Please type your email and a link will be sent to you with all of your information saved or you can copy the link and save it somewhere to access it later.

What were some challenges your club faced? What additional resources or support could have helped you address those challenges?
What went well with your project? What resources or support were most helpful to these successes?
Save or Review/Submit
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Should be Empty:

Dream It, Be It Reporting Form

Project Information

Reported By:

Project Details

Project Details

Participant Demographics

To the best of your knowledge, do the majority of your Dream It, Be It participants experience the following situations:

Girl’s Evaluation Form

Girl’s Evaluation Information

Please read the following statements and report the TOTAL number of participants who selected each response.

Girl’s Evaluation Information

Girl’s Evaluation Information

Participant Contact Information

Save or Review/Submit