PD Activity Reporting Form

1. Please complete the contact information requested below.

First Name Required Question

Last Name

Police Department Required Question

2. Specify reporting period: Required Question

	October 1-December 31, 2009
	January 1-March 31, 2010
	April 1-June 30, 2010
	July 1-September 30, 2010

3. Did you conduct compliance check/minor decoy operations during this reporting period?
Required Question

YesNo

4. If you did not conduct compliance check/minor decoy operations during this reporting period, please tell us what barriers you encountered in implementing this strategy.

Insufficient personnelInsufficient timeStrategy was not necessaryOther (please specify)

5. Do you anticipate completing these activities?

	Yes
	No

6. Please specify when you anticipate completing these activities?

	1-3 months
	4-6 months

7. If you responded "no" to Q.5, have you had any changes in your plans?

	Yes
	No

8. If so, why?

9. Please answer the following questions about compliance checks for on-premise establishments?

	compliance checks conducted	on premise establishments passing compliance check
Number

10. Please answer the following questions about compliance checks for off-premise establishments?

	compliance checks conducted	off premise establishments passing compliance check
Number

11. To what extent do you believe these outcomes have been achieved by compliance check/minor decoy operations?

	Not achieved	Partially achieved	Fully achieved	Not sure
Reduction in underage access to alcohol through retail outlets
Increase in perception of enforcement among youth and young adults
Increase in perception of enforcement among retail liquor licensees
Decrease in past 30 day use of alcohol among teens
Increase in age of onset of first alcohol use
Increase in collaboration on underage drinking enforcement among local police departments
Increase in collaboration on underage drinking prevention activities between law enforcement and local prevention entities

12. Did you conduct underage drinking enforcement operations, other than compliance checks, during this reporting period?
Required Question

YesNo

13. If you did not conduct underage drinking enforcement (other than compliance checks), please tell us what barriers you encountered in implementing this strategy. Required Question

Insufficient personnelInsufficient timeStrategy was not necessaryOther (please specify)

14. If you responded "no", do you anticipate completing these activities?

	Yes
	No

15. Please specify when you anticipate completing these activities?

	1-3 months
	4-6 months

16. If you responded "no" to Q.14, have you had any changes in your plans?

	Yes
	No

17. If so, why?

18. If yes, indicate the types of underage drinking enforcement operations (other than compliance checks) conducted during this reporting period?

	conducted		If yes, # conducted
	Yes	No	If yes, # conducted
Party patrols/enforcement of social host laws	Yes	No
Shoulder tap operations
Parking lot surveillance
Sobriety checkpoints
Emphasis/saturation patrols
Fake ID Enforcement
Source Investigations

19. Number of adult citations issued during enforcement operations conducted during this reporting period:

	Number
Furnishing alcohol
Furnishing a place for minors to drink
Other

20. If other, please specify offenses:

21. If no adult citations were given, please tell us why no adult citations were written.

	there were not infractions of this type
	insufficient resources have limited our ability to monitor all infractions

22. Number of youth citations issued during enforcement operations conducted during this reporting period:

	Number
Possession
Illegal transportation
False identification
OUI/Zero Tolerance
Furnishing Alcohol
Furnishing a place for minors to drink
Other

23. If other, please specify:

24. If no youth citations were given, please tell us why no youth citations were written.

	there were not infractions of this type
	insufficient resources have limited our ability to monitor all infractions

25. Number of administrative citations issued during enforcement operations conducted during this reporting period:

	Number
Sales to a minor
Allowing a minor to remain on premise
Other

26. If other, please specify:

27. If no administrative citations were given, please tell us why no administrative citations were written.

	there were not infractions of this type
	insufficient resources have limited our ability to monitor all infractions

28. To what extent do you believe these outcomes have been achieved by the underage drinking enforcement operations we just discussed?

	Not achieved	Partially achieved	Fully achieved	Not sure
Reduction in underage access to alcohol through adults 21 and older
Increase in perception of enforcement among youth and young adults
Increase in perception of enforcement among parents
Decrease in past 30 day use of alcohol among teens
Increase in perception of risk related to alcohol use among teens
Increase in perception of risk related to underage alcohol use among parents
Increase in age of onset of first alcohol use
Increase in collaboration on underage drinking enforcement among local police departments
Increase in collaboration on underage drinking prevention activities between law enforcement and local prevention entities

29. List the trainings and officer who received trainings pertaining to the STOP ACT Grant in the past 6 months?

	Training Date	Training Title	Person Attending
Training Details