Peace Activity Certificate Tool

- Step 1 of 8

Lesson or Activity Plan Title

Are you Peace Certification Program Participant(s)

Season

Year

Is plan related to an outreach activity created by Mattie’s Foundation?

Which Activity is this related to

Name of Individual, Leader, or Group:

Your Role

e.g., teacher, counselor, parent, librarian...

Name of community/group/school

Location (city, state, country)

Name of activity or lesson plan

Subject/content area(s)

How is this lesson related to Mattie’s poetry or peace message

e.g., which poem, quote, book, etc

Recommended age/grades/developmental level

Who created or adapted this plan

Activity or Lesson Objectives

Relationship to State Standards (if applicable)

Materials needed

Length of activity (minutes, days, weeks...)

Number of children and/or adults impacted:

Preparation steps before activity/lesson

Modifications (for individuals with disabilities, ESL...)

Please describe how the activity or lesson was introduced and carried out

What was said and done first, next. Specific steps in the lesson/activity. Discussion questions and extension activities. Closure or follow-up discussion or activities. Any evaluation of the lesson/activity (what/who/how)...

Please describe participant reflections and responses to the activity/lesson:

What did they like? What would they change? What did they learn? Do they want to learn more? Is this an activity or lesson that families or other groups also learned about or were involved with? Other comments…

Describe your thoughts on “What Next?” (for the participants, for this activity…)

Please describe any suggestions for replication (including modifications)

Please include sample photos (artwork, photos of essays, participants in action, bulletin boards, etc…)

Click or drag files to this area to upload. You can upload up to 10 files.

MATTIE J.T. STEPANEK FOUNDATION

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