Program Info page

Name
Program Name:
______________________________________________________________________________

Main Address
Main Address:
______________________________________________________________________________
______________________________________________________________________________

Billing Address:
____________________________________________________________________________
____________________________________________________________________________

Phone Numbers
Phone Number:  ____________________________________
Fax Number: _______________________________________

Sponsoring Organization
Sponsoring Organization Name: ________________________
Sponsor Website: ___________________________________
Sponsor Phone: ____________________________________
Sponsor Fax: ______________________________________
Separate Sponsor Address:
____________________________________________________________________________
____________________________________________________________________________

Rural/Tribal Status
Rural Status: Urban / Part Rural / Rural
Tribal Status: Not Tribal / Part Tribal / Tribal

Web Addresses
Website: _________________________________________
Facebook:  _______________________________________
Twitter: __________________________________________
YouTube:  ________________________________________
Flickr: ___________________________________________
Instagram: ________________________________________


Program Model page

Enrollment, Attendance, and Program Length
Months over the upcoming year in which you expect to enroll new students:

  • Jan / Feb / Mar / Apr / May / Jun / Jul / Aug / Sep / Oct / Nov / Dec

What is the average program length of this YouthBuild program? __________Months

How many hours per week does this YouthBuild program expect a full time YouthBuild student to be in attendance? __________ hours/week

How many scheduled instructional hours are in a typical day at this YouthBuild program? __________ hours/day

Education
Who provides the educational component at this YouthBuild program?

  • YouthBuild Staff
  • Other Staff    
  • Staff at a Partner Organization

Are students able to earn high school diplomas through this YouthBuild Program?

  • Yes / No

If Yes: These diplomas are granted through a:

  • Traditional Public High School    
  • Charter School    
  • Alternate High School
  • Other: ___________________

If Charter School: Is this YouthBuild program chartered through its state or its district?

  • State    
  • District
If Other: Other Diploma Grantor ____________________
 
What are the requirements for achieving a high school diploma through this YouthBuild Program? 

__________________________________________________________________________

Which career pathways are offered at this YouthBuild program?

  • Construction    
  • Culinary        
  • Technology
  • Healthcare    
  • Other(s): ________________________________________________________________


Green Building Practices
Is this YouthBuild (or its sponsoring organization) a member of the U.S. Green Building Council?     

  • Yes / No

Program Design
Does this YouthBuild program have a Policy Committee with youth involvement?

  • Yes / No

Does this YouthBuild program have a formal substance abuse policy?   

  • Yes / No

Does this program offer financial literacy skills development activities?   

  • Yes / No

What PSE bridging activities does this program offer?

  • Bridge Program
  • Dual Enrollment
  • College Visits or Tours    
  • PSE Preparation Courses
  • Advising by PSE staff    
  • After School Tutoring
  • No bridging activites offered
  • Other(s): ________________________________________________________________

Annual Survey Questions

(asked each October, link found on the Program Overview page)
 
Applicants
Between October 1, 20__ and September 30, 20__ your program enrolled xx Students and exited xx Students. (numbers of students auto-populate with data in DYB)

How many applicants did your program have in this timeframe?
__________ Applicant(s)


How many of those applicants were accepted and started Mental Toughness?
__________ Applicant(s)

Housing Units
Please indicate the total number of housing units completed between October 1, 20__ and September 30, 20__ for each of the following types.

How many new housing units were completed?
__________ New Unit(s)

How many housing units were rehabbed?
__________ Unit(s) Rehabbed

(If one or more units were completed or rehabbed:)

Please indicate how many of the above housing units were built or rehabbed using the following practices.

How many of these units were weatherized?
__________ Unit(s)

How many of these units were Energy Star rated?
__________ Unit(s)

How many of these units were LEED Certified?
__________ Unit(s)

How many of these units used any other green practices?
__________ Unit(s)

 

Article Keywords / Topics: Data Points, List of Questions, Dual Enrollment