Organization / Program Profile for Use by the Center for America
Organization / Program Profile for Use by the Center for America
Instructions:
Please review this section carefully. Then, type the contact information and sign this first page of the form in ink. Then, please fax this first page form to 1-877-992-4747. This section will be held on file and will not be posted as part of your profile. When this section is complete, please go on to the instructions on page 2.
Permissions and Certifications
On behalf of my organization named below, I give my permission for the Center for America to use this information about my organization and its activities without any cost or fee to the Center for America on the CFA website, and to cite my organization’s activities in CFA communications such as directories, emails, newsletters and other media to promote what my organization is doing and the services it provides. I agree to provide updates to CFA should our activities change in any major way. The content I provide below will be viewed by the public, including prospective students, parents, sponsors, employers, government officials and the media. I certify that the information provided in this profile is fully correct and accurate to the best of my knowledge. I also certify that I have the authority on behalf of my organization to provide this information to CFA for public dissemination and to herewith indemnify the Center for America for any direct or indirect liability that arises from the dissemination or non-use of the information I am providing.
Name:
Title:
Organization Name:
Telephone:
Email Address:
Date:
Signature:
Organization / Program Profile for Use by the Center for America
Instructions:
- Please review the following list of topics and use this Word document to type or cut and paste your responses. When it is received via email, CFA will create a PDF of your Profile section (deleting page 1 and these instructions), post the PDF on the CFA website and use the information in other communications media.
- When completed, please email this Word document to . Please do NOT submit this in PDF format.
- For each topic in the profile below, please provide whatever narrative you feel appropriate. Where possible, please observe the suggested word count limitations.
- You are welcome to attach up to five pictures or PDFs you wish to be included in your profile. Please do not embed the picture files in the Word document – attach them separately. Picture files should be in JPG format (not TIFF). Please be sure that the file name of each picture or PDF includes your organization name or acronym. Total submission should not exceed 6 MB (megabytes).
- Please send along an updated profile any time you would like your original profile to be replaced. When submitting an update, please submit the entire profile again rather than just updates for any particular sections.
- Your information profile will be reviewed by our team and posted after it has been accepted for publication.
If you have any questions, suggestions or concerns, please contact:
Amanda Oursler
Outreach Coordinator
Center for America
775-722-3968
Please Type Organization Name Here in Place of This Title
Website:
Website of any student or course related videos:
U.S. Postal Address:
Primary contact name:
Role or Title:
Phone number:
Email address:
Mission and Goals (100 words):
Description of Program (200 words):
Program Leadership (80 words):
Primary Sponsors or Funders:
Courses or Special Areas of Study Offered:
Average (in the classroom) teacher to student ratio:
Performance measurements/ indicators (80 words):
Number of students in the program:
Grades taught/ Ages taught:
Certificates awarded to the students:
Expected number of graduating students in 2011:
Innovative aspects of the program or organization:
Social media (like Facebook, YouTube, Twitter) used by our program:
Application process:
Waiting list length, if any:
Summary Comments, if any: