#10thousandlives application form

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Thank you so much for taking the time to apply for #10thousandlives! We have a number of free hours for consultation, coaching, and training that we will share with child welfare professionals across the United States and Canada! Please complete the following questions to give us a quick snapshot about you and your organization. We will be in touch in the coming weeks after processing the applications to determine how we can best distribute the hours.

If you have any questions or need further information, please contact Melanie Moredock at melanie@forchildwelfare.org.

We are so excited for the #10thousandlives movement!

Email *

Your Name *

Organization Name *

Is your organization based in the United States or Canada? *

Yes

No ** Unfortunately at this time the Institute only has the capacity to serve the US and Canada - we are hoping to expand our staff and our services in the near future!

Please tell us a little about your organization, including the geographic area you serve and in what capacity your organization serves children and families (i.e. case management agency, direct service organization, child placing organization, residential treatment facility, etc.) *

Your Title and Role in the Organization *

Are you, your team, or your organization currently engaging the family members of children you are serving? If so, please briefly outline your current family search and engagement efforts or practices. *

Please briefly outline what you, your team, or your organization wants to improve on in your work to connect children and their families. We are here to collaborate and support. *

Do you have specific ideas of how you envision the Institute assisting? If yes, please outline them here. If not, no worries. Simply indicate that you will want to brainstorm with us if your application is accepted. :) *

Are you willing to assist the Institute by completing brief monthly surveys about how your agency is utilizing #10thousandlives services so we can track our reach and impact? The monthly survey should take approximately 5 minutes to complete. *

Yes

Have you applied for #10thousandlives services previously? *

Yes, I applied and participated in #10thousandlives services

Yes, I applied but my application was not selected

No, I have not previously applied for services

If you'd like, please tell us what your team or organization does well. We are actively building think tanks, a group of forward thinking individuals to lead the country’s child welfare practices. We want to highlight those agencies and workers that are excelling in tough areas.

Anything else we didn't ask about that you'd like us to know?

A copy of your responses will be emailed to the address you provided.

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