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Site Coordinator Network Member Sign Up
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1.
Name
(Required.)
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2.
Email
(Required.)
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3.
Phone
(Required.)
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4.
City
(Required.)
*
5.
Region
(Required.)
Region 1 – Del Norte, Humboldt, Lake, Mendocino, and Sonoma Counties
Region 2 – Butte, Glenn, Lassen, Modoc, Plumas, Shasta, Siskiyou, Tehama, and Trinity Counties
Region 3 – Alpine, Colusa, El Dorado, Nevada, Placer, Sacramento, Sierra, Sutter, Yolo, and Yuba Counties
Region 4 – Alameda, Contra Costa, Marin, Napa, San Francisco, San Mateo, and Solano Counties
Region 5 – Monterey, San Benito, Santa Clara, and Santa Cruz Counties
Region 6 – Amador, Calaveras, San Joaquin, Stanislaus, and Tuolumne Counties
Region 7 – Fresno, Kings, Madera, Mariposa, Merced, and Tulare Counties
Region 8 – Kern, San Luis Obispo, Santa Barbara, and Ventura Counties
Region 9 – Imperial, Orange, and San Diego Counties
Region 10 – Inyo, Mono, Riverside, and San Bernardino Counties
Region 11 – Los Angeles County
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6.
Organization
(Required.)
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7.
Organization Type
(Required.)
School-Based School-Age Child Care
School-Based Afterschool
Community- Based or Nonprofit Organization
Licensed Family Child Care
Park and Recreation
Faith Based Organization
Other (please specify)
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8.
Job Title
(Required.)
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9.
How long have you been in your role as a site coordinator?
(Required.)
*
10.
Are you interested in receiving an application for the Action Team and Leadership Team?
(Required.)
Yes
No
Current Progress,
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