2024-25 Healthy Texas Youth Ambassador Reporting

Please provide the following information:

First Name

Last Name

Please provide your e-mail address:

Please select your County, Region and District
(Region & District will be automatically determined by your county):

County

Region

District

For what date are you reporting?

Month

Year

Please select the type of activity you are reporting:
(Select all that apply)

Please provide the title and a brief description of the activity you are reporting:

How many people did you reach or teach through this activity while serving as an Ambassador?

Hours spent on these activities:
Please round to the nearest quarter hour, e.g.

15 min. = .25, 30 min. = .5, 45 min. = .75

Community Service
Planning Meeting: meeting with agent, committee, or organization to outline program
Program Delivery
Program Preparation: includes project research, setup/cleanup
Training: Summit, monthly web training and local training
Travel
Total