TEMPLATE LOGIC MODEL

	

Inputs	Activities	Outputs	Short Term 
Outcomes	Intermediate 
Outcomes	Long Term 
Outcomes	

						

Outcomes with Indicators and Data Collection Methods

	

Short Term Outcomes	Indicators	Data Collection Methods	Data Sources	Who Collects	

					

Intermediate Term Outcomes	Indicators	Data Collection Methods	Data Sources	Who Collects	

					

Long Term Outcomes	Indicators	Data Collection Methods	Data Sources	Who Collects