Citywide Lights On! Afterschool-Newark 2018: Program Provider Application

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* 1. Organization Information

Organization Name

Name of Contact Person

Contact Number

Contact Email

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* 2. How many youth from your program will attend the Lights On! OST Fair?

0

500

1000

Clear

i We adjusted the number you entered based on the slider’s scale.

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* 3. Do you have any youth that would be interested in showcasing talent on our youth stage?

Yes

No

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* 4. If yes, please explain the talent that the youth would showcase.

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* 5. All providers should have an activity and/or a giveaway for the youth attending the event. Please provide an example such as backpacks, phonecases, pencils, folders etc.

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* 6. Are you interested in hosting a 30 minute workshop/demo of your program for attending youth and families?

Yes

No

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* 7. If yes, please explain the workshop or program demo.

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* 8. Do you have any accommodations for your table? Ex: Near an outlet, extension cords etc.

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* 9. Please select the OST Fair dates that you're available for.

Saturday October 27th, 2018

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* 10. Have you ever participated in a Lights On! Afterschool Event before?

Yes

No