DEPARTMENT:
Checks will be sent to Department Headquarters address
Contact Information for the Person Submitting the Form
Name:
Phone #:
Email:
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Achievement 1 –Vision, Goals, and Strategies have been developed.
$200
Please check this box if you are submitting this form for Achievement 1
Yes, I understand I must submit documentation to verify
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Achievement 2 – Initiatives for each strategy have been developed and prioritized.
$300
Please check this box if you are submitting this form for Achievement 2
Yes, I understand I must submit documentation to verify
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Achievement 3 – Work plans created for each approved initiative.
$300
Please check this box if you are submitting this form for Achievement 3
Yes, I understand I must submit documentation to verify
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Achievement 4 – Implementation of approved initiatives.
$100
Please check this box if you are submitting this form for Achievement 4
Yes, I understand I must submit documentation to verify
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Achievement 5 – Initiatives have been implemented and there are outcomes to report
$100
Please check this box if you are submitting this form for Achievement 5
Yes, I understand I must submit documentation to verify
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Please tell us how the implementation of your initiatives has brought you closer to achieving your goals.
500 word limit
Department President’s E-Signature
(Entering your president’s name in this
box indicates that you have approval from your department president to submit this form.)
Congratulations! You’ve completed phase 1 of your department strategic plan.
We look forward to your future accomplishments in phase 2.