COVID-19 Statewide Out-of-School Time Program Survey

Question Title

* 1. Out-of-School Time Program Contact Name

Contact Name (First and Last Name) *

Program Name *

Address

City/Town *

State/Province

ZIP/Postal Code

Email Address *

Phone Number

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* 2. Is your out-of-school time (OST) program currently closed due to COVID-19?

Yes, my OST program is closed.

NO, my OST program is still operating.

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* 3. If your out-of-school time program is still operating, what services are you providing?

Childcare/Positive Youth Development

Meal Provision

Professional Development for Staff (Virtual)

E-Learning for Youth

Financial Assistance

Other (please specify)

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* 4. Is your program a 21st Century Community Learning Center?

Yes

No

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* 5. What supports does your out-of-school time program need at this time?

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* 6. Additional questions, comments or concerns: