Request edit access
Afterschool / Summer Programs Submission Form
Newark Thrives! is gathering information from Out-of-School Time (OST) providers about their programs in hopes of improving accessibility for Newark youth. Below is the program directory form that we would like for you to complete on your program(s). The directory form will allow us to share your information with youth and families throughout the City of Newark. OST providers will also be able to easily make referrals to other opportunities for youth they are unable to serve in their programs.

Important things to note:

-You will only need to fill out everything this year, moving forward you can update the information you already provided quarterly
-If you have multiple programs, please fill out one form for each one
-If you have multiple sites for the same program, Contact Josephine Russo at jrusso@newark-thrives.org
-If your program only serves one school please complete the form and specify that under eligibility requirements/

For all questions or if you need help submitting:
Please contact Josephine Russo, Director of Research and Evaluation at jrusso@newark-thrives.org or 973-769-5169

Please choose which category your program falls into:
Response Link Capture Email Here
Your answer
Ward
Name of Organization
Your answer
Executive Director
Your answer
Organization Street Address
Your answer
Program Site Address
Your answer
Name of Program
Your answer
Program Website
Your answer
Organization Phone
please answer in following form: 555-555-5555
Your answer
Program Site Phone
please answer in following form: 555-555-5555
Your answer
Name of individual completing this form
Your answer
Title of individual completing this form
Your answer
Direct Telephone Number of individual completing this form
please answer in following form: 555-555-5555
Your answer
E-mail Address of individual completing this form
Your answer
Name of contact for student enrollment
Your answer
Title of contact for student enrollment
Your answer
Direct Telephone Number of contact for student enrollment
Your answer
E-mail Address of contact for student enrollment
Your answer
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms