Virtual Learning Site Host Interest Form
If you have a space in Schuyler, Steuben or Yates County that you are willing to offer as a location for Supervised Virtual Learning and / or Child Care services that will be managed by a registered child care program or an established youth development program, we would like to collect the following information from you. The information you provide will help us start to understand the features of your site and the best fit with the services operated by the partner programs.
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Site Name
Site Address
Site Contact Name
Site Contact Email
Site Contact Phone Number
School District Serving this Community  
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How many rooms would be available for supervised virtual learning and/or child care?
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Are these rooms available every day, Monday through Friday from 8 AM until 5 PM? (Use the "other" area to explain any limitations.)
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Does this site have a current Certificate of Occupancy determining compliance with local building and fire codes?
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Does this site have adequate broadband Internet connectivity to accommodate several students on WiFi?  
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Is the site is able to store food in a safe and sanitary manner?
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Describe the rest room facilities at your site
Does the site have readily accessible outdoor play space which is adequate for active play?  (Use the "other" option if anything needs to be explained)
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If you can offer personnel to assist with the supervision of students, how many people can you provide?  NOTE: All personnel must be at least age 18. All will receive a background check, health check and finger printing. All will receive orientation and/or training to prepare for this role.  
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