Coalition Survey The purpose of this survey is to see if NYS Community Action Agencies are interested in creating a coaltion around database systems such as Captain etc. Question Title * 1. What is the program you wish to form a coalition around? Captain Other (please specify) Question Title * 2. Does your agency use the system for: Community Action Programs (CAP) only? Head Start Programs only? CAP and Head Start Programs together? Question Title * 3. What is your goal for using the system? (Check all that apply.) Tracking data for CAP programs Tracking data for Head Start programs Tracking data for CSBG reporting All of the above Other (please specify) Question Title * 4. What do you hope to get out of participation in the Coalition? (Check all that apply.) Resource sharing Training and technical assistance Leveraging power for program modifications All of the above Other (please specify) Question Title * 5. Please provide any additional comments on your overall experience with the program and what you hope the coalition can accomplish. Question Title * 6. Please provide the following information for your preferred point of contact to participate in a Statewide Coalition: Name: Agency: Email Address: Phone Number: Done
