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* 1. Name

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* 2. Title

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* 3. Organization 

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* 4. Address

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* 5. Email 

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* 6. Phone number (including area code)

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* 7. Briefly describe your experience in the expanded learning field. Specifically, how many years have you been in the field and in what capacities?

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* 8. Describe your experience engaging in CQI or supporting others as they engage in the CQI process. Specifically what systems, processes, and tools have you developed or used to improve quality?

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* 9. Why are you interested in participating in the CQI Guidebook Work Group?

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* 10. What do you think you can contribute to the CQI Guidebook Work Group?

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* 11. I have the support of my supervisor to participate in this work group

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* 12. I could attend a half-day virtual session during the following times (please check all that apply)

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* 13. I understand the responsibilities of this advisory group (outlined on this web page) and commit to these responsibilities. If invited to participate, I also commit to represent the interests of California’s expanded learning system, not just my personal or organizational interests.

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* 14. Additional comments?

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