Thank You for Joining our Movement!

We ask that you complete and submit this short survey for your organization, which will aid us in developing a road map for success.

Milestone Overview:

National MBK Milestones
At the national level, MBK is focused on ensuring that all children:

Enter school ready to learn
Read at grade level by third grade
Graduate from high school ready for college and career
Complete postsecondary education or training
Successfully enter the workforce
Grow up in safe communities and get a second chance if they make a mistake

New York State MBK Goals
In addition to supporting the six milestones set at the national level, New York’s MBK initiative is also committed to:

Ensuring equitable access to high quality schools and programs
Expanding prevention, early warning, and intervention services
Using differentiated approaches based on need and culture
Responding to structural and institutional racism
Making comprehensive and coordinated support services widely available
Engaging families and communities in a trusted and respectful way

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* 1. Organization Name:

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* 2. Organization Type:

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* 3. Contact Person:

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* 4. Title:

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* 5. Email Address:

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* 6. Phone Number:

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* 7. Street Address:

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* 8. Borough:

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* 9. Zip Code:

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* 10. Website:

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* 11. Mission:

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* 12. Communities Served:

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* 13. Our Organization is willing to:

Align or expand the services our organization provides to address one or more of the NYS MBK milestones

Collect and share data on how the services our organization provides are addressing one or more of the NYS MBK milestones.

Host a community outreach event to engage youth and their families and share information about available community resources that support achievement of NYS MBK milestones.

Display and distribute information at our organization’s place of business about available community resources that support achievement of NYS MBK milestones.

Partner with local schools to support achievement of one or more of the NYS MBK milestones.

Start a youth mentoring program.

Personally volunteer to be a youth mentor for an existing mentoring program.

Actively engage and recruit other community partners, faith-based organizations, and local businesses to sign on as participants in the Staten Island MBK Initiative.

Other (please specify)

Thank you so much for your support!