Practitioners Institute Inquiry Form

Question Title

* 1. Enter the name of your organization

Question Title

* 2. Enter your organization's webpage or website link

Question Title

* 3. Enter the contact person for your organization

Question Title

* 4. Enter the contact person's phone number (work and cell)

Question Title

* 5. Enter the contact person's e-mail address

Question Title

* 6. Please select your organization's geographic reach

Domestic (U.S.A)

International

Question Title

* 7. Please select your organization type

Community-Based Organization

Local Education Institution

International Education Institution

Government Agency

Foundation or other administer of funds

Other (please specify)

Question Title

* 8. Please choose a virtual offering (if applicable)

30- Minute Q&A (No presentation or Overview)

1-Hour Information Session (HCZ Overview, History, and Culture)

2-Hour Program Presentations (Overview and 1-2 Specific Areas of Interest)

4-Hour Program Presentations (Overview, 2-4 Specific Areas of Interest, Deep Dive Q&A)

Gold Star 4-Hour General, Opening the Vault (Project activities, planning, and scheduling with breakout sessions)

N/A

Question Title

* 9. Please choose an in-person offering (if applicable)

1-Hour Information Session (HCZ Overview, History, and Culture. No visit to programs) No fee. Conversation only.

3-Hour Site Visit (For groups of 6-12 people only, $3,000) Program presentations with option to visit program(s).

1-Day Learning Series (For groups of 6-12 people only, $6,000) Program Presentations with Site Visits.

2-Day Learning Series (For groups of 6-12 people only, $8,000) Program Presentations with Site Visits.

3-Day Learning Series (For groups of 6-12 people only) $10,000. Program Presentations with Site Visits.

N/A

Practitioners Institute Inquiry Form

Question Title

* 1. Enter the name of your organization

Question Title

* 2. Enter your organization's webpage or website link

Question Title

* 3. Enter the contact person for your organization

Question Title

* 4. Enter the contact person's phone number (work and cell)

Question Title

* 5. Enter the contact person's e-mail address

Question Title

* 6. Please select your organization's geographic reach

Question Title

* 7. Please select your organization type

Question Title

* 8. Please choose a virtual offering (if applicable)

Question Title

* 9. Please choose an in-person offering (if applicable)

Question Title

* 10. Please describe the neighborhood/community you currently serve/intend to serve (size, economic status, density, etc.)

Question Title

* 11. What is your community's strength(s)?

Question Title

* 12. Briefly describe your organization and partner organizations that will participate in the visit to the Harlem's Children's Zone

Question Title

* 13. Why does your organization want to visit?

Question Title

* 14. How many years has your organization been in existence?

Question Title

* 15. What is your organization's budget?

Question Title

* 16. What are your primary funding sources? Please list the percent of your funding that comes from private and public sources.

Question Title

* 17. How many employees (full-time and part-time) does your organization employ?

Question Title

* 18. What element(s) of the Harlem Children's Zone model most interest you and why?

Question Title

* 19. How did you hear about Harlem Children's Zone? (website, social media, news article/tv segment, book, friend or colleague, college, etc.)?

Question Title

* 20. Are you affiliated with any federal initiative (i.e., Promise Neighborhood, Choice Neighborhood, NRI, etc.)?