Conexiones Mid Year Report
To be submitted no later than April 28th, 2023
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Program Site Location
*
Anaheim, CA
Washington, DC
College Station, TX
Houston, TX
Killeen, TX
Richmond, VA
Program Overview
Number of Students Enrolled in the Program
*
When did your first Conexiones session take place?
*
-
Month
-
Day
Year
Date
How often do your students meet?
*
How long is each meeting?
*
What is the physical address of where the meetings take place?
*
How many adult mentors and/or adult volunteers are involved in your program?
*
Please keep track of how many hours adult mentors/volunteers donate throughout the program.This also includes those who help on a one time basis for example; parents who drive the students to field trips.
Please list whole numbers not percentages:
Type a question
How many students in your program are female?
*
How many students in your program are male?
*
How many students in your program are non-binary
*
Please list the number of students in your group that identify as the following ethnicities. Please list whole numbers not percentages in the following section. This section is self-reported.
American Indian/ Native American
*
Asian/ Pacific Islander
*
Latino/a
*
African American
*
White/ Caucasian
*
Other
*
Please list the grades of the students that make up your group. Please list whole numbers not percentages in the following section.
6th Graders
*
7th Graders
*
8th Graders
*
9th Graders
*
10th Graders
*
11th Graders
*
12th Graders
*
How many of the students in your group identify Spanish as the language that is primarily spoken at home?
*
How many of the students in your group identify English as the language that is primarily spoken at home?
*
How many of the students in your group identify a language other than Spanish or English as the language that is primarily spoken at home?
*
What is the cumulative GPA of all the students in your program?
*
Have all students completed their entry survey?
*
Yes
No
Have all parents/guardians filled out the media waiver and parent/guardian survey?
*
Yes
No
Do you plan on hosting any activities for parents this year such as parent orientation?
*
Please upload your receipts here and current budget
*
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Please upload your student activity form here:
*
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Please upload your attendance sheets here:
*
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Please upload any photos or videos you may have here, you can email them if the file is too large.
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Have you or the students run into any issues or have any concerns you'd like to share with the LULAC team?
*
Submit
Should be Empty: