PEP Data Collection - Partners
Organization Name
Facilitator's Name
First Name
Middle Name
Last Name
Suffix
Facilitator's Email Address
example@example.com
PEP Module - standalone workshop (please submit documentation below)
Please Select
Barriers to Learning
College and Career Ready
Community Organizing
Cultural Equity
Data & Accountability
Homework
Leadership & Advocacy
Leadership Styles
Learning Communities
Learning Styles
Learning Support at Home
Media 101
Parent Engagement
Personal Leadership Plan
Resource Roundtable
School Boards
Special Needs
Technology / Digital Native
Other
Please specify, if other.
PEP Program/Session (please submit documentation below)
Please Select
PEP Early Childhood Development (ECD)
PEP Graduation Ready
PEP Leadership
Language
Please Select
English
Spanish
Other
Please specify, if other.
Upload flyer/documents/marketing announcement
Browse Files
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of
Upload photos/group graduation photo.
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of
Demographic Data (please fill in as much as possible)
Data
# of participants
# of ethnicities served
# of males
# of females
# of transgender/non-binary/other gender identification
# of low income
# of participants between the ages of 18-24
# of participants between the ages of 25-34
# of participants between the ages of 35- 44
# of participants between the ages of 45-54
# of participants between the ages of 55 and up
# of parents with ELD learners
# of Parents with Special Ed students
# found information valuable
# found information relevant
Ethnicities Value
Name of Ethnicities
John Smith
Jean Smith
Jun Smith
Comments/feedback/testimonials
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