HACLA NGs Gym Services - Community Partners - Describe Your Services

NGs Gym Collaborator Services 2024

Complete this survey if you want to provide sports related or non-sports related youth services at the Nickerson Gardens Gym, Education and Community Center. We request you complete this survey BEFORE YOU START.

LAM responsibilities include tracking and coordinating all programs and individual contractors working at Nickerson Gardens. We value ongoing process improvements, such as communication, transparency, coordination, and collaboration with each service provider at Nickerson Gardens.

Whether you are long-standing or relatively new to Nickerson Gardens Gym, we want you there. While the basketball and boxing programs are strong at Nickerson Gardens Gym, we recognize that some youths want workshops, games, activities, art & history, STEM, technology, and health education field trips too.

We create and maintain ongoing opportunities for public and private partners and individual subject experts to join the monthly success circle for NGs. We publish a calendar of educational activities for youth and families afterschool and during summer.

Educational classes, indoor and outdoor activities, offered through the gym will excite Nickerson Gardens children about learning and familiarize them with the benefits of physical fitness, mental fitness, college readiness and preparation roadmaps.

If a question does not apply to you, please indicate "not applicable."

Learn more at www.nickgardensgym.org

Questions, contact Daniel Neely

Email: Lambookkeeper2@gmail.com

Phone: 323-273-4586 (leave a message if no answer; we will call back within 24 hours).
Note: This electronic transmission, and any documents attached hereto, may contain confidential, legally privileged, proprietary data, and/or non-public personal information as defined in the Gramm-Leach-Bliley Act (collectively, “Confidential Information”). If you have received this electronic form in error, please notify the sender and delete the electronic message. Any disclosure, copying, distribution, or use of the contents of the information received in error is strictly prohibited. By accepting and reviewing any Confidential Information contained in this electronic transmission, LAM agrees to maintain and protect the confidential nature of the Confidential Information in accordance with the applicable law and to ensure nondisclosure except for the limited purpose for which it is being provided. The content of this form is strictly confidential and only intended for the LAM and HACLA staff. It is forbidden to share the form or its contents with any third party without the sender’s written consent.

Question Title

* 1. Organization Physical Address

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 2. Organization Name

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* 3. Contact Person Name at Organization

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* 4. Phone number

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* 5. Contact person Email Address

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* 6. Describe the Services you plan to provide at Nickerson Gardens

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* 7. Select your proposed service(s), check all that apply

Basketball

Boxing Fitness/Skills

Boxing and Brunch/Mental Health for Athletes

Soccer/USA Soccer

Afterschool tutoring

Youth Development, Enrichment and Mentoring

LGBTQIA+ Youth Programs

Dance (Girls Class)

Boys ROC/Girls Roc

Chess Club

College Readiness and High School Graduation Support

Digital Media Training

Balloon Artist Club

Baseball (pending Summer 2025)

Football Clinics /LA RAMS

Mental Health Services

Health Education and Promotion

Senior Programming/Services

Nutrition and Cooking Class/Demos

Field Trips and Events

Art In the Gardens

Performing Arts and Cultural Celebrations

Outdoor Fitness and Mindfulness

Environmental Education

Life Skills Classes

Nature Exploration and Gardening

In-Door/Outdoor STEM Lab

Technology/Coding

Other (please specify)

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* 8. Do you have at least one half time or one full time, Spanish Speaking Staff/ contractor in Your Program?

Yes

Other (please specify)

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* 9. What qualifies you for the services you propose to provide? Give brief background on organization, years in services, education, training and or certification, license if applicable.

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* 10. What day(s) of the week will/are your services provided at NGs?

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Other (please specify)

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* 11. What hours are your services to be provided at the NGs Gym and/or outside the playground?

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* 12. Specifically, where are your services to be provided on-site at NGs? (If applicable)

NG Gym

Back of Gym outside

Front of Gym outside

Jobs Plus Bungalow

Sage Center

Computer Lab

Other

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* 13. How many youth participants do you plan to serve each month?

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* 14. Of this total, how many youth participants will be NGs' youth/ages below?

NGs youth ages 3-5 years old

NGs youth ages 6-14 years

NGs youth 15-18 years

Young People/Adults (ages 19 and up)

Non NGs youth between 10-17 years old

Other population

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* 15. How many of the participants to be engaged/served are in the following ethnic/racial groups?

African American

Hispanic/Latino/x

Asian American

White

Biracial

Other

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* 16. How many adults do you anticipate on site from your program and describe their roles?

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* 17. How many outreach activities were conducted to increase HACLA residents' participation? write NA if not applicable

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* 18. Please describe these outreach activities. (If applicable)

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* 19. Will you conduct outreach to NGs residents on site canvassing? If yes, how often?

Yes

Flyers

Canvassing

Other (please specify)

None of the above

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* 20. Please describe any factors that may have caused change in participation. write NA If Not applicable.

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* 21. Are you interested in hiring youth workers in your program?

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* 22. Are you interested in hiring adult residents (HUD Section 3 Local Hires) in your program?

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* 23. If yes, briefly tell us more about your workforce needs.

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* 24. Upload Images about your services if applicable

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 25. Upload images from your services if applicable

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 26. Explain how your project will improve the outcomes for Nickerson Gardens Residents and youth?

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* 27. Describe any incidents and/or occurrences (i.e., accidents, criminal activities) that occurred on the Premises and indicate whether these incidents were reported to the appropriate authorities. If applicable.

HACLA NGs Gym Services - Community Partners - Describe Your Services

NGs Gym Collaborator Services 2024

Question Title

* 1. Organization Physical Address

Question Title

* 2. Organization Name

Question Title

* 3. Contact Person Name at Organization

Question Title

* 4. Phone number

Question Title

* 5. Contact person Email Address

Question Title

* 6. Describe the Services you plan to provide at Nickerson Gardens

Question Title

* 7. Select your proposed service(s), check all that apply

Question Title

* 8. Do you have at least one half time or one full time, Spanish Speaking Staff/ contractor in Your Program?

Question Title

* 9. What qualifies you for the services you propose to provide? Give brief background on organization, years in services, education, training and or certification, license if applicable.

Question Title

* 10. What day(s) of the week will/are your services provided at NGs?

Question Title

* 11. What hours are your services to be provided at the NGs Gym and/or outside the playground?

Question Title

* 12. Specifically, where are your services to be provided on-site at NGs? (If applicable)

Question Title

* 13. How many youth participants do you plan to serve each month?

Question Title

* 14. Of this total, how many youth participants will be NGs' youth/ages below?

Question Title

* 15. How many of the participants to be engaged/served are in the following ethnic/racial groups?

Question Title

* 16. How many adults do you anticipate on site from your program and describe their roles?

Question Title

* 17. How many outreach activities were conducted to increase HACLA residents' participation? write NA if not applicable

Question Title

* 18. Please describe these outreach activities. (If applicable)

Question Title

* 19. Will you conduct outreach to NGs residents on site canvassing? If yes, how often?

Question Title

* 20. Please describe any factors that may have caused change in participation. write NA If Not applicable.

Question Title

* 21. Are you interested in hiring youth workers in your program?

Question Title

* 22. Are you interested in hiring adult residents (HUD Section 3 Local Hires) in your program?

Question Title

* 23. If yes, briefly tell us more about your workforce needs.

Question Title

* 24. Upload Images about your services if applicable

Question Title

* 25. Upload images from your services if applicable

Question Title

* 26. Explain how your project will improve the outcomes for Nickerson Gardens Residents and youth?

Question Title

* 27. Describe any incidents and/or occurrences (i.e., accidents, criminal activities) that occurred on the Premises and indicate whether these incidents were reported to the appropriate authorities. If applicable.

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* 28. Please share anything else you want us to know about your project?