BTE Evaluators (Pilot) Independent Evaluator Submissions BTE Site*Athens, GeorgiaBajos de Haina, Dominican RepublicBound Brook, NJ(3)Bracknell, UKEast London, South Africa (ELSA)Franklin Township, NJHelsingborg, SwedenJacksonville, FloridaLancaster, PALas Piedras, Puerto RicoLimerick, IrelandMexico City, MexioNew Brunswick, NJ (6)Norristown, PAOrange County, CAPuebla, MexicoSingaporeSkillman, NJSydney, AustraliaThailandTrenton, NJ (3)Tswelopele, South AfricaWarsaw, IndianaYokenam, IsraelYumbo, ColombiaPlease select the relevant site (One site only)Name of Evaluator/Organization*Kelley Research AssociatesPoint ResearchJ Solomon Consulting LLCRutgers UniveristyUniversity of DerbyMlenga G JereLund UniversityUniversity of LimerickHenrietta Szolde InstituteUniversity of CapetownPlease idenitfy the evaluator or organizationSubmitter Name*Please enter the name of submitter (your name)Name of the Deliverable* Evaluation Agreement Baseline Data Year 1 Annual Report Year 1 Academic/Survey Data (Master File) Year 2 Annual Report Year 2 Academic/Survey Data (Master File) Year 3 Annual Report (Final Report) Year 3 Academic/Survey Data (Master File) Other: Please specify Please select all that applies Is this the first evaluation agreement for this site?* Yes No Please select Yes or NoAre you making a change to your evaluation agreement?* Yes No Please select Yes or NoSummary of Changes to Agreement*Revise Focus Group Date(s)Revise Debrief Meeting Date(s)Update Contact InformationRevise Scope (change in evaluation activities or mode of evaluation)Choose oneAttachment Drop files here or Please upload file(s)Comments/Special Notes (Optional)Date* Date Format: MM slash DD slash YYYY Please enter today's dateConsent I agree to the privacy policy.
