YESS Cohort Renewal Form

YESS Cohort Renewal Form

If you have previously submitted a Group Questionnaire and signed a Group Agreement for your organization, use this abbreviated form for all subsequent launches. Please complete one form per class and provide one Syllabus per class. Submit at least 2 weeks prior to your cohort launch date.
Contact Name

First NameLast Name
Contact Business Title
Personal E-mail
Work Phone

Area CodePhone Number
School or Group Name
Company City/State/Country

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Who is Your ActionCOACH Sponsor?
Group Information

Tell us a little about your group/cohort.
How many students do you anticipate will enroll?
What is the age range?
What language do they speak?
What is your anticipated Start Date?
What is your anticipated Completion Date?
COHORT FACILITATION: Choose all that apply

Faculty member will facilitate classesA local ActionCOACH will facilitate classesA sponsor will facilitate classesOther
COHORT STRUCTURE: Choose all that apply

Students will meet virtuallyStudents will meet in-personWe do not know at this time
COHORT INVESTMENT:

We are investing $100 per student paid by the first day of class; ACF will cover the remaining $200 cost per student. Pay at: https://actioncoachfoundation.org/cohortgroup-fees-checkout/We are applying for partial funding dispensation, with the understanding that there will be some cost that must be paid by one week after the first class. Copy this link to your URL to apply: https://forms.gle/EQfKCxzqkgMQsQ9j9
GROUP SYLLABUS:

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Upload your Group Syllabus here. Cancelof
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YESS Cohort Renewal Form

Group Information