Dream Chaser Kids Program Planning Form

1

School/Organization Name* This field is required.

2

Type a question

3

First Name* This field is required.

4

Last Name* This field is required.

5

Contact Email Address* This field is required.

example@example.com

6

Contact Phone Number

Please enter a valid phone number.

8

Estimated Number of Students* This field is required.

9

Goals for Your Dream Chaser Kids Program* This field is required.

Teamwork & Collaboration

Leadership Skills

Creative Problem Solving

Confidence Building

STEM Engagement

Other

10

Preferred Program Format* This field is required.

In-person

Virtual

Hybrid

11

Preferred Start Date* This field is required.

Date

13

Preferred Time of Day

Morning

Afternoon

Evening

14

Do any students require special accommodations?

Yes

No

15

Please describe any special needs or accommodations

16

Anything else we should know to help plan your Dream Chaser Kids experience?

17

What kinds of data or evidence are most important for you and your funders? (check all)* This field is required.

Attendance and participation

Student talent profiles and career interests

Number and quality of completed projects / StoryBuilder pages

Pre/post student surveys (confidence, sense of purpose, etc.)

Academic-aligned artifacts (writing samples, presentations)

Parent or staff feedback

18

Upload any existing survey tools or reporting templates (optional)

19

Do you have existing survey questions or reporting requirements we should align with?

20

Funding source (e.g., Southside Promise, city, school budget, church, other)

21

Estimated budget range available for this program

22

Who helps approve this program (names/roles), and by when do you hope to decide?

23

Is this intended as:* This field is required.

A one-time pilot

A recurring seasonal program

A year-round pathway

24

How did you hear about Dream Chaser Kids?

25

Anything else we should know to make this a great fit for your students and community?