<p> NEW JERSEY DEPARTMENT OF EDUCATION SURVEY OF AFTERSCHOOL PROGRAMS </p><p>DISTRICT INFORMATION</p><p>1. District Name: ______</p><p>2. County/District/School (CDS) Code: ______- ______- ______</p><p>AFTERSCHOOL PROGRAMS</p><p>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.</p><p>Yes. If yes, please proceed with questions 4-10. No. If no, please skip to question 10.</p><p>4. Primary District Afterschool Contact Name: ______Telephone: ( )______ext.______E-mail: ______</p><p>5. What is the current enrollment of all schools in your district that offer a comprehensive afterschool program? ______</p><p>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): ______</p><p>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? .</p><p>Yes. If yes, please proceed with question 9 and 10. No. If no, please skip to question 10.</p><p>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): ______</p><p>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.</p><p>Yes No </p><p>THANK YOU!</p><p>2</p>