New Jersey Department of Education s7

NEW JERSEY DEPARTMENT OF EDUCATION SURVEY OF AFTERSCHOOL PROGRAMS

DISTRICT INFORMATION

1. District Name: ______

2. County/District/School (CDS) Code: ______- ______- ______

AFTERSCHOOL PROGRAMS

3. Do any schools in your district offer a comprehensive afterschool program? Definition: A comprehensive afterschool program is a school-sponsored coordinated program of activities for youth. In general, these programs: . serve at least six or more children; . have at least two types activities; . have at least two teachers; . operate at least two hours per day; . operate at least two days per week; and . operate at least six weeks during the year.

Yes. If yes, please proceed with questions 4-10. No. If no, please skip to question 10.

4. Primary District Afterschool Contact Name: ______Telephone: ( )______ext.______E-mail: ______

5. What is the current enrollment of all schools in your district that offer a comprehensive afterschool program? ______

6. Of those schools that offer a comprehensive afterschool program, what types of activities do they offer? Please check ALL that apply. Academic Enrichment/Tutoring/Homework Help Arts/Culture Sports/Recreation/Health/Social Emotional Learning Leadership/Career Development Technology/Computers Other (please specify): ______

7. Of those schools that offer a comprehensive afterschool program, which grade levels do they serve? Please check all that apply. K 5 10 1 6 11 2 7 12 3 8 4 9 8. Do any of your schools receive child care voucher/subsidy funds to provide afterschool programming to eligible students? .

Yes. If yes, please proceed with question 9 and 10. No. If no, please skip to question 10.

9. What is (are) the funding source(s)? Please check ALL that apply. A. Federal Government (e.g. Title I, OJJDEP, 21st CCLC, etc.) B. State Government (e.g. Child Care Vouchers/Subsidies, TANF, JJC, etc.) C. Local Government (e.g. County/Municipal Government, Library, Parks/Rec., etc.) D. Private Corporation(s)/Foundation(s) E. Program/Parent Fees F. Other (please specify): ______

10. Does your district offer a summer enrichment program? Definition: A summer enrichment program is a school-sponsored coordinated program of activities for youth that operates in the summer. In general, these programs: . serve at least six children; . have at least two types activities; . have at least two teachers; . operate at least three days per week; . operate at least three hours per day; and . operate at least four weeks during the summer.

Yes No

THANK YOU!