Effective programming lies at the heart of any attempt to support disconnected young people.

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Organization
Borough
   

Leadership Contact Information
Primary Contact
Name
Address
City
State
Zip
Phone
Email
Secondary Contact
Name
Address
City
State
Zip
Phone
Email
Outreach/Referral
Name
Address
City
State
Zip
Phone
Email

Primary Service area (pick one)
Job training and/or placement
Intermediary organization
Job training and/or placement

Individuals Served:
Client age range X to Y
Subpopulation served:
All Out of School youth meeting age
Criminal Justice (select only if your services / admissions are targeted to this population)
Foster Care (select only if your services / admissions are targeted to this population)
Female (select only if your services / admissions are targeted to this population)
Male (select only if your services / admissions are targeted to this population)
Other

Education (pick one)
High School Diploma and testing at 11th grade level
High School diploma required for service
High School diploma or GED required
No diploma but individual must test to read at the grade
No educational requirement for service

Size/Scope of organization (pick one)
Large provider with multiple sites (list below)
Large provider single site
Neighborhood CBO

Services Provided
Workforce Development
Soft skills/job readiness
Hard skills training: list all fields and any certifications offered:
Field: Certifications:
Field: Certifications:
Field: Certifications:
Job Retention Counseling. Length of Tracking:
6 months
1 year
2 years
More than 2 years
Career Counseling
Internships
Mentoring Program
Job Shadowing
Transitional jobs
Other
Education
Basic Literacy
Pre GED
GED Training, testing, assistance
Financial literacy
College Counseling

Social Services Provided
Case management
Drug Treatment
Housing
Counseling
Individual
Group
Crisis Prevention
Primary Person
Approach/philosophy:(youth development, workplace simulation, etc...please list all that apply)

Client Demographics
Age Breakdown
Gender Breakdown
% of Female
% of Male
Ethnicity Breakdown
% of African American
% of Hispanic / Latino
% of Caucasian
% of Asian
% of Native American
% of Arab
% of Other