1. AfterZone / After-School Program Information

Thank you for taking the time to complete this questionnaire.

The information you share here will help you as a science education program provider as well as the Providence After School Alliance (PASA) and the Providence Public Schools to find out about field trips or short-term in-class presentations you can offer and the ways they might be aligned with Providence Public Schools core science curriculum for middle school youth.

The questionnaire will help determine how your field trip or in-class presentations match up with the science curriculum topic areas for the middle school grade levels.

As you complete the questionnaire, please note that:

* this survey is related only to MIDDLE SCHOOL science learning programs.
* the attached survey is designed for you to share information related to an ONGOING, MULTI-SESSION PROGRAM offered through the other AfterZones (or other after-school setting).
* if you have additional ongoing programs, please complete an additional survey for each of those experiences.

Also, there are TWO ADDITIONAL questionnaires which might be of interest to you:

* one with questions about how your multiple-session after-school or in-school program aligns with state academic standards.
* one with questions about field trip or one-time in-class presentation alignment with Providence's middle school science curriculum.

Both of these can be accessed from a link on PASA's homepage: www.mypasa.org

If you have any questions about the questionnaire or would like to forward electronic versions of materials which you feel are essential to adequately portray your program(s), feel free to contact Patrick Duhon, Director of Expanded Learning for both PASA and PPSD, at patrick.duhon@ppsd.org.

Again, thank you for completing this questionnaire.

Question Title

* 1. Program Contact Information

Question Title

* 2. Please provide a brief description of your program:

Question Title

* 3. Please describe your experience in providing this program (e.g., for how long? for whom? for how many youth? in what context?, etc.):

Question Title

* 4. If the opportunity arose, would you be willing to offer components of this program as a field trip or in-class presentation?

Question Title

* 5. Additional comments or information: