Lancaster Partnership for Learning Equity: PARTNER ORG Survey

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* 1. What is the name of your organization?

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* 2. Please provide contact information for the point person for this project:

Name

Address

Address 2

City/Town

ZIP/Postal Code

Email Address

Phone Number

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* 3. What is the nature of your organization?

Community Center

Social Services agency (food access, case management, etc.)

Childcare Facility

Youth services agency

School

Other (please specify)

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* 4. What type of program will your organization offer?

Remote: My org will connect families with this opportunity, support enrollment & serve as a material pick-up site, but students will complete program FULLY at home

Hybrid: My org will connect families with the opportunity, support enrollment, serve as a material pick-up site, & host students on-site or in person occasionally for enrichment activities, added learning, academic support, etc.

In-person: My org will incorporate the BellXcel Remote curriculum as a part of our regular programming and students will engage in learning on-site supported by program staff

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* 5. How many slots would you like to reserve for your organization?

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* 6. Of the slots you are requesting, please estimate the age range of the students you will recruit to fill them. (example: of our 20 slots, 5 will be designated for pre-k, 10 will be elementary age & 5 will be middle school age students).

# of pre-k slots

# of rising kindergartners through rising 4th graders slots

# of rising 5th graders through rising 9th graders slots

Question Title

* 7. What additional support will your organization require to make the BellXcel Summer Learning Program a success for your team and for the families you serve?

Lancaster Partnership for Learning Equity: PARTNER ORG Survey

Question Title

* 1. What is the name of your organization?

Question Title

* 2. Please provide contact information for the point person for this project:

Question Title

* 3. What is the nature of your organization?

Question Title

* 4. What type of program will your organization offer?

Question Title

* 5. How many slots would you like to reserve for your organization?

Question Title

* 6. Of the slots you are requesting, please estimate the age range of the students you will recruit to fill them. (example: of our 20 slots, 5 will be designated for pre-k, 10 will be elementary age & 5 will be middle school age students).

Question Title

* 7. What additional support will your organization require to make the BellXcel Summer Learning Program a success for your team and for the families you serve?

Question Title

* 8. Do you have any other questions, comments or feedback?