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Learning Extension Centers (LECs) Survey
Please complete this short survey to assist us in providing more information to our Principals and families. Thank you!
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* Indicates required question
Organization Name
*
Your answer
We are interested in:
*
Please check all that apply.
Being a Learning Extension Center (LEC) to support Columbus students (sign-up at:
www.forcolumbusstudents.com
)
Supporting LECs by partnering, volunteering, or donating
Applying for the Governor's Office of Faith-Based & Community Initiatives grant (
www.faith-based.ohio.gov
)
Applying for Children's Hunger Alliance food (Contact Jared Buerger,
jbuerger@childrenshungeralliance.org
)
Other:
Required
Contact's First Name
*
Your answer
Contact's Last Name
*
Your answer
Contact's Email address
*
Your answer
Contact's Phone number
*
Your answer
Location of LEC (address)
*
Your answer
If you are planning to work with a school, please indication which school(s) below.
*
Your answer
Please use the images below to identify which Regions you will serve:
*
Region I (west-side)
Region II (east-side)
Region III (near east and south sides)
Region IV (north and northwest sides)
Region V (northeast side)
Region VI (feeder patterns/clusters)
Other:
Required
CCS Region Map
List of CCS Schools by Region
Registering and enrolling students:
*
We will have a registration process.
Our program is open to students already in our program.
Our registration is currently full.
We plan to work with students in special populations (ELL, special education, gifted, etc). Please include more information in the "Other" box below
Other:
Required
Capacity: How many students do you anticipate serving?
*
Your answer
Is there any additional information you'd like to share?
Your answer
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