Pathways Interest Form

1.Organization Name
2.Your Name
3.Your e-mail address
4.Best number to reach  you
5.What is the address of where the workshop will take place?
6.Which workshop would you like to host?
7.If you chose College Prep, how many workshops can you host?
8.If you chose Early Childhood, how many workshops can you host?
9.If you are hosting an Early Childcare workshop, are you able to provide childcare?  (This is not a requirement.)

10.When would you be able to host the workshops?  If you have specific dates, please include below.  Otherwise, please include   the month, and if possible, the week.

11.When would you like your workshop?
12.Our workshops are traditionally conducted in Spanish.  Will you need your workshop to be in English?
13.Would you be able to register at least 35 people to attend the workshops, promote workshops, and collect RSVPs?
14.Please include information about how you will reach out and share the opportunity with parents. 
15.Please include any additional information that is important for us to know about your community or parents and  children that would allow us to better serve them.
16.Please list the type of space the workshop will be held in (i.e. classroom, gym, auditorium).


17.Who will be the site contact? Include name and title.
18.Please provide site contact email and phone number below.
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