General Information
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電子郵件 *
Contact Name (First and Last Name) *
Contact Phone Number *
Organization Name *
Please provide a brief description of your NTI Support Program *
Please provide a description of any additional activities/supports available at your location
How many students are you currently serving? *
What grades bands are the students in whom you are currently supporting? (check all that apply) *
必填
How many paid staff are currently working at your location? *
How many volunteer staff are currently working at your location? *
Is your organization able to provide written documentation of background checks for all employees and volunteers? *
Is your organization able to provide a written safety plan for students in attendance which adhere to both CDC and Kentucky State "Healthy at Work" guidelines? *
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