Building Power In Community & Beyond Mapping NYC Services for Young Women of Color Survey

Question Title

* 1. Please fill out this information as completely as possible
If N/A please write N/A

First name of person completing this survey

Last name of person completing this survey

Title of person completing this survey

Name of organization

Address (central office if there are multiple sites)

Borough

State/Province

ZIP/Postal Code

Email Address

Phone Number

Question Title

* 2. Please check all that apply to indicate the area(s) your organization serves

Brooklyn

Staten Island

Manhattan

Bronx

Queens

Across New York State

Across several states in the United States and/or we are a national organization

Our agency serves internationally

I am an individual and not associated with an organization

Other (please specify)

Question Title

* 3. If you are from an organization, please indicate to the best of your ability the percentages of types of services your organization provides

	Does not apply to our organization	Less than 10%	10%-20%	21%-30%	31%-40%	41%-50%	51%-60%	61%-70%	71%-80%	More than 80%
Advocacy with and on behalf of issues affecting communities	Advocacy with and on behalf of issues affecting communities Does not apply to our organization	Advocacy with and on behalf of issues affecting communities Less than 10%	Advocacy with and on behalf of issues affecting communities 10%-20%	Advocacy with and on behalf of issues affecting communities 21%-30%	Advocacy with and on behalf of issues affecting communities 31%-40%	Advocacy with and on behalf of issues affecting communities 41%-50%	Advocacy with and on behalf of issues affecting communities 51%-60%	Advocacy with and on behalf of issues affecting communities 61%-70%	Advocacy with and on behalf of issues affecting communities 71%-80%	Advocacy with and on behalf of issues affecting communities More than 80%
Direct Service with individuals	Direct Service with individuals Does not apply to our organization	Direct Service with individuals Less than 10%	Direct Service with individuals 10%-20%	Direct Service with individuals 21%-30%	Direct Service with individuals 31%-40%	Direct Service with individuals 41%-50%	Direct Service with individuals 51%-60%	Direct Service with individuals 61%-70%	Direct Service with individuals 71%-80%	Direct Service with individuals More than 80%
Direct Service with families	Direct Service with families Does not apply to our organization	Direct Service with families Less than 10%	Direct Service with families 10%-20%	Direct Service with families 21%-30%	Direct Service with families 31%-40%	Direct Service with families 41%-50%	Direct Service with families 51%-60%	Direct Service with families 61%-70%	Direct Service with families 71%-80%	Direct Service with families More than 80%
Legal Services	Legal Services Does not apply to our organization	Legal Services Less than 10%	Legal Services 10%-20%	Legal Services 21%-30%	Legal Services 31%-40%	Legal Services 41%-50%	Legal Services 51%-60%	Legal Services 61%-70%	Legal Services 71%-80%	Legal Services More than 80%
Organizing with and by communities	Organizing with and by communities Does not apply to our organization	Organizing with and by communities Less than 10%	Organizing with and by communities 10%-20%	Organizing with and by communities 21%-30%	Organizing with and by communities 31%-40%	Organizing with and by communities 41%-50%	Organizing with and by communities 51%-60%	Organizing with and by communities 61%-70%	Organizing with and by communities 71%-80%	Organizing with and by communities More than 80%

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* 4. Please add the link to your website below:

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* 5. Does your agency currently provide gender-specific services to women, girls, and/or non-binary or gender nonconforming youth of color under the age of 24?
If you are not associated with an organization please select no.

Yes

Question Title

* 6. In a couple of sentences, please describe your interest in supporting this work.

Thank you for your interest. Please feel free to contact us at services@buildingpowernyc.org

Question Title

* 1. Please fill out this information as completely as possibleIf N/A please write N/A

Question Title

* 2. Please check all that apply to indicate the area(s) your organization serves

Question Title

* 3. If you are from an organization, please indicate to the best of your ability the percentages of types of services your organization provides

Question Title

* 4. Please add the link to your website below:

Question Title

* 5. Does your agency currently provide gender-specific services to women, girls, and/or non-binary or gender nonconforming youth of color under the age of 24? If you are not associated with an organization please select no.

Question Title

* 6. In a couple of sentences, please describe your interest in supporting this work.

* 1. Please fill out this information as completely as possible
If N/A please write N/A

* 5. Does your agency currently provide gender-specific services to women, girls, and/or non-binary or gender nonconforming youth of color under the age of 24?
If you are not associated with an organization please select no.