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Coalition Survey
The purpose of this survey is to see if NYS Community Action Agencies are interested in creating a coaltion around database systems such as Captain etc.
1.
What is the program you wish to form a coalition around?
Captain
Other (please specify)
*
2.
Does your agency use the system for:
(Required.)
Community Action Programs (CAP) only?
Head Start Programs only?
CAP and Head Start Programs together?
*
3.
What is your goal for using the system? (Check all that apply.)
(Required.)
Tracking data for CAP programs
Tracking data for Head Start programs
Tracking data for CSBG reporting
All of the above
Other (please specify)
*
4.
What do you hope to get out of participation in the Coalition? (Check all that apply.)
(Required.)
Resource sharing
Training and technical assistance
Leveraging power for program modifications
All of the above
Other (please specify)
*
5.
Please provide any additional comments on your overall experience with the program and what you hope the coalition can accomplish.
(Required.)
*
6.
Please provide the following information for your preferred point of contact to participate in a Statewide Coalition:
(Required.)
Name:
Agency:
Email Address:
Phone Number:
