2017 Women in Wind Application
Please fill out the information below to the best of your ability. This information is kept anonymous and used for reporting purposes. It is important for CSC to gather this information to continue serving deserving populations and make informed program decisions.
Organization Information
Organization Name
Your answer
Street Address, City, Zip
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Phone Number
Your answer
Executive Director/Principal
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Primary Contact Person
Name
Your answer
Title
Your answer
Best Contact Phone Number
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Email
Your answer
Person Signing Agreement
Name
Your answer
Person Signing Letter of Recommendation
Name
Your answer
Group Demographics
Participant Age
How many participants do you anticipate? If you are not completely sure, put the highest number that you expect.
Your answer
How many participants are English language learners?
Your answer
How many participants are in Vermont through the Refugee Resettlement Program?
Your answer
How many participants identify as white?
Your answer
How many participants identify as Latino/Latina?
Your answer
How many participants identify as Black or African American?
Your answer
How many participants identify as Bi-racial/mixed race?
Your answer
How many participants identify as other?
Your answer
If participants are under the age of 18, how many live in a single-parent household?
Your answer
Additional Group Information
What are your group's concerns about sailing?
Your answer
Do any students in your group require specific accommodations?
Your answer
What goals do you have for your group?
Your answer
Any suggestions for the CSC instructors?
Your answer
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