Ohio Out-of-School-Time Programs Data Map
This form will be used to create a list and map of out-of-school time programs operating in Ohio for kids K-12. This map can be used by parents and caregivers to find programs; help OAN and other advocates determine gaps in service areas or populations, and connect educators and providers with other providers in their area. PLEASE FILL OUT ONE FORM PER SITE IF YOUR PROGRAM OPERATES MULTIPLE SITES!
Organization name: *
Your answer
Program/Site Name: *
Your answer
Program Street Address (number and street name only): *
Your answer
Program City: *
Your answer
Program Zip Code: *
Your answer
Program County: *
Program Contact Phone Number: *
Your answer
Program Contact Email Address: *
Your answer
Program Website:
Your answer
Program type:
Licensure: *
Funding sources (check all that apply): *
Required
Program fees (check all that apply):
School district(s) served:
Your answer
Grades served (check all that apply): *
Required
Number of students served (approximate daily attendance): *
Your answer
When does the program operate (check all that apply): *
Required
What days of the week is the program open (check all that apply):
Meals served (check all that apply):
Activities offered (check all that apply):
Other services offered (check all that apply):
Program description (1 paragraph or less):
Your answer
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