NEW SCHOOL ENQUIRY

The Y Schools' Breakfast Program

School Assistance Enquiry Form
N.B. For your online enquiry to submit, you will need to answer every question (enter text into every text box). Put NA next to any Q that is not applicable.
What region / area is your school located?*

LoganIpswichBrisbane (South)Brisbane (Eastern Suburbs)Brisbane (North) & Moreton BayBrisbane (South/West)Outside of these areas but able to collect supplies from one of these areas.Outside of these areas and too far away to collect supplies.Other
Name of School*
Suburb where your School is located*
Does this request have support of the Principal*
Please answer the following questions about your school's breakfast program (or proposed program):
Are you seeking support for a 'new' or 'existing' breakfast program?*

New Breakfast ProgramExisting ProgramOther
How many mornings a week would your school like to run a breakfast program?*
N.B. Schools who can only run a breakfast program once or twice a week (i.e. less than 3 days) may not be eligible for direct deliveries* or loan of large equipment). *At this stage the YMCA is only able to deliver supplies directly to schools located in Logan, Ipswich, Brisbane & Moreton Bay Regions
If your school can only run its breakfast program one or two mornings a week, will your school be able to collect food supplies from Logan or a neighbouring school (if avail as an option)?*

NA -we can run our program 3 or more days a weekWe can collect supplies from LoganWe can collect from another school if avail as an optionNo, we are unable to collect from anywhereOther
Estimated number of students who will attend your breakfast program per day? *
How long will the breakfast program run for each morning:*

20 minutes max25 minutes max30 minutes max30+ minutesOther
Where will your school run the breakfast program:*

From within or outside of the Tuck ShopFrom within or outside of a Hall KitchenFrom within or outside of the Staff Lunch RoomFrom within or outside the Special Education UnitOutside of a Classroom and undercoverOther
What access and visibility will the breakfast program have (select all that apply):*

A busy well known area where lots of students goA quite area where not many students goA closed off area where students will need to seek permission to enterA small area where student numbers will need to be limitedOther
Who will the breakfast program be open to:*

Any student within the whole school who wishes to participatePrep students onlyPrep and Junior students only (in a P-12 school)Special Education students onlyOnly students teachers identify as hungryOther
How long does your school intend to run a breakfast program?*

One term only (as a trial)Two or three terms (as a trial)Long term / ongoingOther
How should we contact you?

PhoneEmail
Does your school currently receive any 'donations of food' for its Breakfast program? If so, please list the type of food below and who donates them (N.B. This will not disqualify you from receiving for support from the Y).*
Does your school receive any Funding $ specifically for its Breakfast Program? If so, please enter below the $ amount received each year (enter NA or 0 if zero). N.B. This will not disqualify you from applying for support from the Y. *
Please provide information that demonstrates the School's need for a Breakfast Program*
Do you have a team of volunteers or teachers to assist you with running the breakfast program?*

Yes, I have a team ready to helpNot yet, but I am close to having a full teamNo, but I can run it on my ownOther
Comments
Your Full Name*
Your position or role*
Your Email
Your Email:*
example@example.com
Your Phone Number*
How did you hear about the YMCA Schools' Breakfast Program?*

Google searchWord of mouthI (or someone in my school) used to work in a school with a Breakfast Program supported by the YMCAThrough Scripture UnionOther
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The Y Schools' Breakfast Program