After School Matters Rolling Interest Form

1

Before we begin, how did you hear about After School Matters?* This field is required.

Google or search engine

Social Media

Another website

Recommended by friend or colleague

Event

Other

2

Would you like assistance in determining if you would like to partner with After School Matters as an Employee Instructor or a Community Based Organization?* This field is required.

YESNO

3

Are you licensed to do business in Illinois?

YESNO

4

Can your organization make supply purchases before the beginning of a program session?

YESNO

5

Can your organization pay your instructors for hours worked in a timely fashion, and without relying on the disbursement of the CBO payment advance?

YESNO

6

Do you have, or can you acquire, After School Matters' Insurance requirements?

YESNO

7

Are you willing to name After School Matters and the Board of Education of Chicago and the City of Chicago as additional insured parties?

YESNO

8

Can your organization identify key instructors and staff for your program?

YESNO

9

Can your organization provide training for your instructors and staff to meet After School Matters quality and compliance expectations?

YESNO

10

Does your organization have a system to track receipts, invoices, and instructor hours?

YESNO

11

Are you interested in working with After School Matters as an Employee Instructor?

YESNO

12

Are you interested in working with After School Matters as a Community Based Organization?

YESNO

13

What type of partnership are you interested in having with After School Matters?* This field is required.

Employee Instructor

Community Based Organization

14

Are you a current program provider with After School Matters?* This field is required.Current program providers are defined as providers offering programs during the Summer, Fall, or Spring of the current session year.

YESNO

15

Are you a current employee instructor with After School Matters?* This field is required.Current program providers are defined as providers offering programs during the Summer, Fall, or Spring of the current session year.

YESNO

16

Are you a current employee instructor with After School Matters?* This field is required.Current program providers are defined as providers offering programs during the Summer, Fall, or Spring of the current session year. If you select "No", you will be directed to the Careers page.

YESNO

17

Are you proposing a new program idea (different content area/focus) or are you looking to expand or replicate your current program to another site or location?* This field is required.

18

Are you proposing a new program idea (different content area/focus) or are you looking to expand or replicate your current program to another site or location?* This field is required.If you are proposing a new program idea, you will be directed to the Careers page.

19

Organization Name* This field is required.

20

Name* This field is required.

First Name

Last Name

21

Email* This field is required.

example@example.com

22

Web address (if applicable)

23

Phone Number* This field is required.

24

What is your program idea?* This field is required.After School Matters is seeking programs for 15-30 Chicago high school participants (Instructor: Teen Ratio - 1:15) between the ages of 14 to 18 for any given program year.

25

Please describe in detail what Chicago high school teens will be doing during a typical day in your program.* This field is required.

26

Describe how you would promote inclusivity in your program to ensure that it is an emotionally safe and supportive environment for Chicago high school teens of diverse cultures, backgrounds, orientations, and abilities.* This field is required.

27

What content area does your program proposal fall under?* This field is required.

Arts

Communications & Leadership

Sports

STEM

28

Please clarify the type of Art program you would like to provide.* This field is required.

29

Please clarify the type of Communications & Leadership program you would like to provide.* This field is required.

30

Please clarify the type of Sports program you would like to provide.* This field is required.

31

Please clarify the type of STEM program you would like to provide.* This field is required.

32

What is your program location preference?* This field is required.Please select all that apply

33

What community area(s) do you prefer?

34

What community area(s) do you prefer?* This field is required.Please select no more than three (3) options. For reference, you may view the previous snapshot.

35

When are you available to run a program?* This field is required.• Summer: 6 weeks, daily Monday through Thursday/Friday (based upon the program model), 4 instructional hours per day. • Fall and Spring: 10 weeks per session, Monday through Friday (after school hours) and/or Saturday, 75 instructional hours per session (based upon the program model).

36

Please upload a completed curriculum plan for your program. Access our planner template at ASM Program Planner Fillable* This field is required.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

37

What is the name of the program you are looking to expand/replicate?* This field is required.

38

What is the branch of your current program?* This field is required.

39

What is the name of your current program manager?* This field is required.

40

Please explain why you want to replicate your program (add similar program to another site/location) and/or expand your program reach. Specify any preliminary work you completed.* This field is required.

41

What community area(s) do you prefer?

42

Identify the location and/or community area where you are looking to replicate your program. Do you have existing relationships or partnerships in this location/community area? If so, please confirm the point of contact at new proposed location and enter the address of the location. * This field is required.

43

Please select the Branch for your proposed expansion.* This field is required.

44

Are you open to replicating your program in other communities?* This field is required.

YESNO

45

Get Page URL

46

Interview Selection

47

Selecting Program Manager/Director