Provider Check-In Project Connect February 12th 2026 Provider Check In/Out Project Connect February 12th 2026 Provider Check In/Out Organization Name Name * Name First First Last Last Email * Date * Time * 121234567891011 : 0030 AMPM Are you checking IN or OUT? * SELECTCheck-InCheck-Out Select “Check-In” when you arrive at the event. Select “Check-Out” before you leave to report your impact. Check In Reminder Please be prepared to track the following during today’s event. You’ll be asked to report these at check-out: ✅ A success story or interaction highlight ✅ Number of guests who approached your table ✅ Number of guests who actually received services ✅ Number of services provided to those guests Thanks for being part of making Project Connect impactful. Check Out Success story you had with a guest from today: * Please share one meaningful interaction or moment of impact from today. Number of guests who APPROACHED my table How many guests stopped by your table, whether or not they received services? Number of guests who RECEIVED services at my table How many of the guests who approached actually received a service? This number must be less than or equal to the number who approached. Example: If 7 guests approached your table but only 4 received services, enter 4. Number of SERVICES the guest received while at my table * How many total services were provided to guests at your table? This number must be equal to or greater than the number of guests served. Example: If 4 guests received services, and each received 3 services, enter 12. Table location 1 Star 2 Stars 3 Stars 4 Stars 5 Stars Services available for guests 1 Star 2 Stars 3 Stars 4 Stars 5 Stars Host site 1 Star 2 Stars 3 Stars 4 Stars 5 Stars Location was beneficial for guest * 1 Star 2 Stars 3 Stars 4 Stars 5 Stars Please provide any additional information you would like us to know: Submit Start Over If you are human, leave this field blank.
