Tech Prep Module Report Form

                                                         Date of module____________

Type of Prep:                     ______   New

                                       ______   Repeat High Prep

                                       ______   Repeat

                                       ______   Exchange

Title of Module: _______________________________________________

Presenter ____________________________________________________

Host _______________________________  Host participating ________

Class involved in module: _______________________________________

Brief explanation of module:




Response of students to module (From a CAT – clearest or muddiest point, focused listing point, etc.):




Comments from Presenter:


Comments from Host: