POST DELEGATION OUTREACH REPORT
International Program of the New York State Labor-Religion Coalition

NAME:

TODAY'S DATE:

DELEGATION YOU WERE ON:

PLEASE LIST YOUR OUTREACH ACTIVITIES SINCE YOUR LAST
REPORT. (PLEASE USE THE BACK FOR MORE ENTRIES.)

SPEAKING
TO WHOM—WHEN— HOW MANY— FUTURE CONTACTS
1.

2.

3.

PUBLICATIONS Please include a copy of your article or reflection
NAME OF PUBLICATION— READERSHIP— CONTACT
1.

2.

3.

OTHER EVENTS
EVENT— AUDIENCE— COMMENTS
1.

2

3.

CONTACTS FOR FUTURE DELEGATIONS
NAME— ADDRESS— EMAIL
1.

2.

3.

Please print, complete and mail this form to International Program, NYS Labor-Religion Coalition, 800 Troy-Schenectady Rd., Latham, NY 12110-2455. Call 518/ 213-6000, ext. 6294 for more information. Revised 3/02 THANK YOU.