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?
Early Childhood
College Prep
Both Workshops
7.
If you chose College Prep, how many workshops can you host?
One
Two
Three
Not applicable. I am not hosting a College Prep workshop.
8.
If you chose Early Childhood, how many workshops can you host?
One
Two
Three
Not applicable. I am not hosting an Early Childhood Workshop.
9.
If you are hosting an Early Childcare workshop, are you able to provide childcare? (This is not a requirement.)
Yes
No
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?
Saturday, 9am-1pm
Weekday evening (6pm-10pm)
Other (please specify)
12.
Our workshops are traditionally conducted in Spanish. Will you need your workshop to be in English?
No, my workshop will be in Spanish.
Yes, I would like my 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?
Yes
No
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.
Current Progress,
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