Skip to content
MRBN Resilience Building: 2019 Environmental Scan
*
1.
What is the name of your program/primary initiative?
(Required.)
*
2.
Briefly describe your program/primary initiative and please include your organization or agency affiliation.
(Required.)
*
3.
What are the key goals/outcomes of your program/primary initiative?
(Required.)
*
4.
What is your target population? Select all that apply.
(Required.)
Children
Adolescents
Families
Businesses
Coalition
Community members
Other (please specify)
*
5.
What is the area, county, or state that this program/primary initiative covers?
(Required.)
*
6.
What is the time frame and/or duration?
(Required.)
*
7.
What is the funding source(s)?
(Required.)
*
8.
Is there any data, literature, or resources supporting your work?
(Required.)
*
9.
Are there links to more information or resources that you could share?
(Required.)
*
10.
Who is the lead person on your program or primary initiative?
(Required.)
Name
Email
Phone number
*
11.
Would you like to highlight your program at a future MRBN meeting?
(Required.)
Yes
No
*
12.
Do you have any technical assistance or training need that MRBN can provide or facilitate?
(Required.)
*
13.
MRBN is always willing to connect you with other programs and leaders across Maine to build resilience, would you be interested in this?
(Required.)
Yes
No
Current Progress,
0 of 13 answered
