WPC X3^zޓᶶ0Րm5Qռ!`4NOkXF]+;@Xs^kvBkEњ;`ft8x X'>pG&CP6 ::7?JgP)xQ$[Tvb#֣{#d95s>;(K2TWUj~Ei^M# Wv$r) 9 T&NTS]*ڲm- 6]} 0T8O .}qeU).t,ʖəE)3 /Sn}FF /x[P I%lHOLDS/pzv*2=6`Or='vk \)!+ẠxL NOS\P{qL~*Kxe~怱|=:Xp4~M޶;?׍>,]v#tUN= % 0( 2 w 4  0c Nu w 0w  1u ^ 1= m? 0V 72 0 0 0f 0- 0 1,2 0 N2,2^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ D5 B  AO1 0D 0D;; D- D5 B D5 B3 D3P B D3 B D/ D5 B*T D3~ B* D5 B* D3: B*m D5 B7 B7 D5: Bo D5 D-SAVIN 2055DP PCL 60(9 Z 6Times New Roman RegularX($mailto:mkh@srskansas/orgD23|x(;3$2#  0  .3  0   (O;$0  2#  a  .3  0` (#(#Level 1Level 2Level 3Level 4Level 53#37=CIQYag1.a.i.(1)(a)(i)1)a)mL3A U(b$0  0` (#(#2#   .3  0 ` (#` (#i)(xir$0  0` (#(#0 ` (#` (#2#(  0  )3  0 (# (#($0  0` (#(#0 ` (#` (#0 (# (#2#(  a  )3  0h(#(#(F$0  0` (#(#0 ` (#` (#0 (# (#0h(#(#2#(   )3  0h(#h(#($0  0` (#(#0 ` (#` (#0 (# (#0h(#(#0h(#h(#2#  0  )3  0(#(#({$0  0` (#(#0 ` (#` (#0 (# (#0h(#(#0h(#h(#0(#(#2#  a  )3  0p(#(# x>\Gaeimquy}Bullet ListBullets Listmailto:jkeyton@ku.edumailto:lba@srskansas.org(O$ ((^9:(mailto:mkh@srskansas.orgWWWW)!dxdx dYZ[]C<< CLevel 1Level 2Level 3Level 4Level 5(3$ !  ($$   1  )!dxdx____)!dxdx  daaaa)!dxdxP Pdcccc'dxd deeee'dxd daa' dxdhhhh)!dxdx&0 d djjjj'dxd&P d dllll)!dxdx&p d Pdnnnn'dxd&p Pd dpqpq)!dxdx3+0 d d d3+0 d d dssss)!dxdx dWWWWW'dxdW'dxd !  _TRX3'LetterX3' Letter3'LetterX3' Letter3'LetterTe 'G)XX'5^5r!SavethisformtoyourPCdrivefirst;thenemailcompletedformto:  Lori_Alvarado_,_SRS_ԀSpecialAssistant,4 ;O  5  _lba_@_srskansas_6O  7 9Ԁ(Toenterdocumentationintoreport)  andalsotoJoanne_Keyton_,KU,4 ]O  5  jkeyton@ku.edu6*O>  7 lԀ(Touseforevaluationpurposes) l   _SRS_ԀCommunityCapacityBuildingTeam  (x  TRAININGDOCUMENTATIONofONEKANSAS  V (tomeetrequirementof32hoursoftrainingover12mo.period)XX  4 #XXX#   &aX%XXXTitleofTrainingEvent:򀀀   NameofOrganization/Audience:򀀀󀀀 Z   #XXX%&aXn#NameofFacilitator:___________________________________ T  0  _SRS_ FacilitatorsAffiliation:____________(KCMetro,NE,SE,_SoCent_,West,Wichita, 2  _RMHF_,_KNI_,_Larned_,Parsons,_OSH_,CO(CentralOffice)) (#(# 0  FacilitatorsAffiliation:_________________( ifOtherStateAgcy/CommPartner ) (#(# NameofCoFacilitator:_________________________________ Z  0  _SRS_Ԁ CoFacilitatorsAffiliation:______________(KCMetro,NE,SE,_SoCent_,West, 8 Wichita,_RMHF_,_KNI_,_Larned_,Parsons,_OSH_,CO(CentralOffice))f(#(# 0  CoFacilitatorsAffiliation:______________ (ifOtherStateAgcy/CommPartner) D(#(# NumberofParticipants:________________DateofTraining:_____________________  Hours:(pleasemarkXtoindicateiftrainingwasFormalorInformal) l ____Formal(allmodulespresented) J 0  _______enternumberofhoursbymultiplyingtotalnumberofmodulespresentedby2(x(#(# 0  PleaseindicatewhichmoduleswerepresentedbymarkingwithX:V(#(# 0  _____AssetMapping;______Collaboration;_____CommunityDiversity;4(#(# 0  _____ConflictResolution;_____FacilitativeLeadership;_____OutcomeBasedPlanning;  _____StrategicCommunication;_____CivicEngagement.(#(# ____Informal(Tools/Strategiesonlywerepresented;completemoduleswerenotpresented) \ 0  ______enternumberofhoursofTools/Strategiestraining:  (#(# 0  PleaseindicatewhichTools/StrategieswerepresentedbymarkingwithX:!h!(#(# 0  ___Buildingnetworks;___Creatingnorms;___Identifyingindividualsstrengths;!F"(#(# 0  ___Buildingtrust;___Identifyingcommunityassets;___Definingroles;"$#(#(# 0  ___Definingvision,mission,guidingprinciples;___Buildingonthepast;#$(#(# 0  ___Definingstrategies,outcomes,actionsteps;___Establishingfeedbacksystem;$%(#(# 0  ___Consensusdecisionprocesses;___Strategiccommunication;___Accountability;n% &(#(# 0  ___Focusedgroupwork;___EvaluationandCelebration;___StakeholderMapping;L&!'(#(# 0  ___MeetingThemes;____Timeline_ԀProcess;___AppreciativeInquiry;*'z"((#(# 0  ___Logicmodel;___Strategicmanagement;___Visiondrivenstrategicchangemodel(X#)(#(# LocationofTraining:______________________ )%+ __9K)XG)X9Pleaseforwardcompletedformto:Lori_Alvarado_,_SRS_ԀSpecialAssistant,4 O  5  lba@srskansas.org6:ON  7 q!| *%, 4 eO  5  6O  7 eGAsummaryreportwillbecompiledquarterlyandmadeavailabletotheappropriate +&- Director/Superintendent,andtotheKansasHealthFoundationandWichitaStateUniversity.