* 1. Please tell us the name of your agency and who your agency contact will be in fiscal year 2013, Including their name, title, phone number, and email address.

* 2. Please tell us briefly how your agency is embedding (or planning to embed) the Strengthening Families™ Protective Factors into your early childhood services for children and families. (Please include funding opportunities you have applied for but not yet received).

* 3. Please tell us how you would like to collaborate with Strengthening Families Illinois in the next fiscal year (examples: provide training or parent cafes, serve on workgroup, in-kind contribution of meeting space, undertake a collaborative project, MOU)

* 4. Please tell us the most important things you feel that Strengthening Families Illinois can do to serve young children and their families in the next fiscal year.

Thank you very much for your commitment and continued partnership. We look forward to continuing the collaboration with your agency in this next year and we will see you at the Leadership Team meeting on September 21 (location TBD)

T