The Boston Cares Bed Project Prospective Partner Form 100% of survey complete. Question Title * 1. The Bed Project was started in 2014 with a goal of making 500 high quality beds for children in need this year. Having a bed of one's own improves health and education outcomes for children and builds up their self esteem. As of June 1, more than 200 high quality solid wood beds have been built by corporate and individual volunteer groups and distributed to children through multiple non-profit agencies in Eastern Massachusetts and Southern New Hampshire. Please tell us how your organization found out about The Bed Project. Colleague Friend Media coverage Outreach by a Boston Cares volunteer or staff member Boston Cares Web site Boston Cares social media (Twitter, Facebook, Linked In, etc.) Other Please be as specific as possible: Question Title * 2. Is your organization interested in distributing beds to families in need? Please note that the families must be pre-qualified by a social worker or case worker who can verify the need. Yes No Question Title * 3. Please tell us the best person to contact at your agency. Name: Title: Organization: Address: City/Town: State: -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP: Country: Email Address: Phone Number: Question Title * 4. What is your Web address? Question Title * 5. What geographic area does your organization serve? Select all that apply. Boston (please explain below if specific neighborhoods) North of Boston, including Lynn, Salem, Beverly South Shore, including Quincy, Fall River, New Bedford, Brockton Western suburbs, including Framingham Worcester area Merrimack Valley, including Lowell, Lawrence, Haverhill Western Mass. New Hampshire All of Massachusetts Greater Boston Eastern Massachusetts Other or specific location: Question Title * 6. Please tell us your organization's mission. Question Title * 7. What kinds of living situations are common for the children/families your organization works with? Currently in or moving into foster care Coming out of foster care and returning to a family home Living in temporary shelters Moving out of shelter into permanent housing Living in public housing Living under the poverty line Other (please specify) Question Title * 8. Roughly how many children does your agency work with in a year who need TODDLER beds? (Please note that when beds are given to children in shelters that the bed is intended to go with the child when moving into permanent housing. Toddler beds are currently available.) 1-5 6-10 11-20 21-30 31-50 51-100 101-500 More than 500 Other (please specify) Question Title * 9. Roughly how many children does your agency work with in a year who need TWIN beds? (Please note that when beds are given to children in shelters that the bed is intended to go with the child when moving into permanent housing. Twin beds are in development.) 1-5 6-10 11-20 21-30 31-50 51-100 101-500 More than 500 Other (please specify) Question Title * 10. Roughly how many children does your agency work with in a year who need BUNK beds? (Please note that when beds are given to children in shelters that the bed is intended to go with the child when moving into permanent housing. Bunk beds are in development.) 1-5 6-10 11-20 21-30 31-50 51-100 101-500 More than 500 Other (please specify) Question Title * 11. Do you have storage where you could hold beds at your site until they are needed by your clients? (Note that all beds easily disassemble and stack for ease of transportation and storage.) Yes No Not sure Comments: Question Title * 12. Do you now or have you in the past placed Boston Cares volunteers at your organization? Yes No I don't know If yes, please explain further: Question Title * 13. Does your organization have 501(c)(3) status? Yes No Not sure In process We are a state/government agency Other (please specify) Done