Organization Information

Fill out your organization information below. Complete the Program Site Information for each program site you would like to have participate on the following pages.

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* Organization

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* Contact Person

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* Billing Information
An invoice for $75 per participating site will be sent after signing a Memorandum of Agreement to cover the cost of the data management system. A $15 added fee per account may apply if additional user or external assessor accounts are requested. A $15 added fee per PQA tool may apply if more than 2 assessment tools per site are requested. Optional external assessments conducted by Alaska Afterschool Network may incur travel costs and will be outlined in an separate agreement. 21st Century Community Learning Centers will be responsible for covering staff time of external assessments conducted by Alaska Afterschool Network staff to be outlined in a separate agreement.

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* Executive Director

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* Does the Executive Director support full participation in this Initiative?

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* How many program sites do you plan to have participate?

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* Each program site comes with a login to the data management system, Scores Reporter. Fees for additional user accounts will be included on the invoice sent after a Memorandum of Agreement is signed.

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* Briefly describe what your organization/program hopes to achieve as a result of your participation in the initiative? What difference will participation in the initiative make in your program?

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* Briefly describe your organization's capacity to take part in the initiative. How will you meet the expectations?

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* Anything else you want us to know?

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* For programs who have engaged in the YPQI for at least 2 years: Are you interested in engaging in elements of the Social Emotional Learning Program Quality Assessment (SELPQA)? The Alaska Afterschool Network is offering assessment support and training opportunities around selected items in the SELPQA. We will reach out with more details if interested. A small additional fee for this service may apply.