Forest Heights School Community Partner Afterschool Interest Survey

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The purpose of 21st CCLC grants is to fund quality afterschool programs that provide opportunities for academic enrichment and tutorial services to help students meet state academic standards. Other programs, activities and services that can be offered include youth development activities, service learning, nutrition and health education, drug and violence prevention, counseling, arts, music, physical fitness and wellness, technology education, financial literacy, environmental literacy, mathematics, science, career and technical programs and internship or apprenticeship programs. All activities should reinforce and complement the regular academic program of participating students. Programs are also required to offer families of students served by community learning centers opportunities for active and meaningful engagement in their child's education, including opportunities for literacy and related education development.

Would you like to support engaging, high quality afterschool programs for Forest Heights STEM Academy students? We want to hear from you!

1. AGENCY NAME

2. YOUR NAME

3. EMAIL

4. PHONE

5. Are you interested in serving as a partner to support after school and summer programs at Forest Heights STEM Academy?

Yes

Maybe

Clear selection

6. If you are interested in serving as a program partner, please indicate which type of program you can assist.

Afterschool

Summer

Both

7. Please indicate the type of support you would like to provide to Forest Heights STEM Academy students & families:

Mentoring

Hands-on educational activities

Assistance with service learning activities

Assistance with parent and family program

Assistance with field trips

Volunteer recruitment

Community outreach and communication

Staff recruitment

8. Would you be interested in providing ongoing (weekly) activities or periodic special programs and events?

Ongoing clubs or activities

Periodic programs & special events

Both

9. Would you be willing to host program activities at your agency site?

Yes

Maybe

Clear selection

10. If you are willing to host activities, please describe what type/s of amenities and features are available at your site.

As part of completing our application for funding, we will need to discuss partnership details and obtain documentation (a letter outlining the partnership and a collaboration form) from you. Who will serve as your primary agency contact?

Contact phone number

Contact email

Submit

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