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BK - 00026 PG <br />Class started on <br />Number of sessions <br />and ended on <br />Number of total participants <br />Number of participants who completed at least 80 % of sessions <br />Leader Names 1. <br />2. <br />Place /Location <br />Required documentation: Attendance Sheet, Class Evaluation <br />Please submit completed form with required documentation quarterly (10.10.14, 1.9.15, 4.10.15, <br />7.10.15) to: <br />Ashley Price <br />Triangle J Council of Governments <br />4307 Emperor Blvd., Suite 110 <br />Durham, NC 27703 <br />919- 558 -2711 <br />Fax: 919- 549 -9390 <br />Email: a a aprice(a)-ticoa.org <br />Thank you for your ongoing support in promoting health and well -being in the senior community! <br />TJAAA Addendum Form July 2014 - June 2015 <br />