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Ready To Learn: Family Book Club Reporting Form

Use the "tab" key to move from field to field. Do NOT use the "enter" key as that will submit your report before it is complete.
Book Club Site Name:
First Name:
Last Name:
Phone:
Email:
Date of Session:	Use mm/dd/yy format (i.e. 11/04/05)
Theme:	Other:
Featured Book:
PBS KIDS Program Clip Used:
Workshop Length:	(60 min, 90 min, etc.,)
1. Number of... parents/adult family members that attended either a Family Book Club session or home visit. Total number of parents/adult family members trained using the theme and book listed above. Children residing in the homes of the parents/adult family members who attended either a Family Book Club session or home visit. (Count the number of children, birth-8 years, who reside in the parent's/adult family member's home. Count only those children whose parents/adult family members attended either a Family Book Club session or home visit.) English Books Given Away Spanish/Other Language Books Given Away Bilingual Books Given Away (Each month you may keep one book for your classroom/organization collection. If you do so, please include that copy in this count.) 1a. Did you conduct any home visits? Yes No If yes, how many: Please be sure that the number of adults, children, and books are included in question 1. 2. Did you: conduct a warm-up/focus activity? Yes No assign the Learning Triangle "homework"? Yes No review the "homework" assigned at the previous session? Yes No 3. Did you talk about: the learning triangle? Yes No reading to your children on a daily basis? Yes No talking with your children on a daily basis? Yes No asking your children questions and answering your children's questions? Yes No teaching new words to your children? Yes No child development? Yes No forming partnerships with "school" personnel and communicating with them about your children's progress? Yes No Explain what you did during the session(s) to address parent/adult family member involvement? media literacy? * Yes No * (Media Literacy as defined by the Alliance for a Media Literate America -- Media literacy empowers people to be both critical thinkers and creative producers of an increasingly wide range of messages using image, language, and sound. It is the skillful application of literacy skills to media and technology messages. As communication technologies transform society, they impact on our understanding of ourselves, our communities, and our diverse cultures, making media literacy an essential life skill for the 21st century). Ready To Learn (explaining either the local or national activities and goals)? Yes No Other (please specify) 4. What strategies did you use when reading the book? (Remember you do NOT have to use ALL of these strategies each time you read a book). Before reading the book, I: read the title, author, illustrator asked children to predict what the story was about previewed the story introduced new vocabulary words connected the store to the children's real-life experiences gave the children a reason to listen to the story During the time I read the book, I; pointed to pictures important to the meaning of the story asked the children, "what do you think will happen?" asked questions important to the meaning of the story answered children's questions After reading the book, I: asked guided questions important to the meaning of the story did sentence completion activities connected the story to the children's environment/daily life did story retelling activites 5. What handouts/resources did you distribute: 6. Please provide an anecdote from this training (the best thing about the session; something somone said regarding the book, their family, or session; tell about the experience participants have had as a result of what they have gained from attending book club sessions).