First name: * Last name: * Email: * Phone: * Title: * Agency: * Street: * City: * State: * ZIP: * Length of time with current employer: Length of time in current position: Number of employees or volunteers you supervise: Total number of staff members in your organization: Current operating budget of your organization: Which of the following DYCD contract do you receive?: --None--DiscretionaryOut of School TimeRunaway Homeless YouthTeen ActionCornerstoneYoung Adult Internship ProgramNeighborhood Development AreasOther Size of DYCD contract: --None--Less than $15,000$15,001 to $25,000$25,001 to $50,000$50,001 to $100,000$101,001 to $200,000$201,001 or more Please tell us about your organization, including the service issue(s) your organization addresses, population served, organizational structure, etc. (Maximum 500 words): Please tell us about your experience in the nonprofit field; also describe your current role within the organization, including the number of years in the role, and your key responsibilities and accomplishments. (Maximum 500 words): Type the text shown: * Send me a copy * These fields are required.
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