Aquila is Seeking Intervention Programs Around the Country

Aquila is gathering information about Intervention Programs Around the Country

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* 1. Please list the information below

Contact Person: *

Program Name: *

Address:

Address 2:

City/Town: *

State: *

ZIP:

Country:

Email Address: *

Phone Number: *

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* 2. Approximately how many participants join your program each year? (Include participants who have been in your programs from a previous enrollment)

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* 3. Briefly describe your program type?

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* 4. How do you involve victim advocacy programs (if at all) in your day-to day programming?

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* 5. Do you provide programming for women who use force?

Yes

No

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* 6. If YES, Please estimate numbers of participants who are “Women who use force” program participants in an average year

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* 7. Any other information you want to share: e.g. What are three difficult problems your program is facing right now?