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Montana Statewide Program Database Entry Form

This database helps to map and collect data about out-of-school time programs and the youth they serve in Montana. By filling out this form, you permit Montana Afterschool Alliance to share your program information on the MTAA website and with stakeholders. While your program might look different this year due to Covid-19, we still encourage you to provide information that accurately reflects your operations at the moment. We recognize some programs operate in more than one site. *Each site should fill out a separate entry.*

Covid-19 Impact
We understand Covid-19 has impacted many programs in different ways. Please let us know the current state of your program. If your program is not currently fully operating, please provide data based on your most recent experiences.
  • Open and functioning normally
  • Open and operating more hours than usual
  • Open and operating fewer hours than usual
  • Serving youth only online
  • Serving youth both in person and online
  • Unable to serve youth at this time
What is the name of the site you operate?
Please provide a one sentence description of your program.
(If applicable)
Please enter the contact information for the individual filling out this form if different than the information provided above.
What best describes your current role within the organization?
Number of Years of Experience in Afterschool/Out-of-School-Time/Youth Development:
The following questions refer to the racial breakdown of staff members within your organization.
Organization Funding
How is your program funded? Check all that apply.
  • 21st Century Community Learning
  • Child Care and Development Fund
  • Parent Fees
  • Municipal Funding
  • Private Grants/ Donors
  • Government Grants
Fee Structure
Please describe the fee structure of your program. Check all that apply.
  • Fee-Based
  • Free for All
  • Full Scholarship for Low-Income Families
  • Partial Scholarship for Low-Income Families
  • Other
School or Community
Which of the following best describes your organization and site?
When does your program provide services?
  • Before School
  • After School
  • Summer Program
  • Weekend Program
Please provide the total number of youth served in your program during the school year. If a child attends more than one program during the school year, please only count them once.
Please provide the total number of youth served in your program during the summer. If a child attends more than one program during the summer, please only count them once.
The following questions refer to the racial breakdown of youth served within your organization.
What percentage of youth served come from a military home?
What percentage of youth served come from a two-parent home?
What percentage of youth served come from a single-parent home?
What percentage of youth served come from a non-traditional home (non-parent guardian, foster care, etc.)?
What percentage of community youth receive Special Education services?
Using the link here, provide the percentage of students receiving 'Special Education Services'. This is found under the 'District Characteristics' tab. At the top left, choose the school from which you have the most representation in your program site. Visit this link to find the school profile: https://gems.opi.mt.gov/SitePages/DistrictInfo.aspx
What percentage of community youth receive free and reduced lunch services?
Using the link provided, provide the percentage of 'Economically Disadvantaged' students. This is found under the 'District Characteristics' tab. At the top left, choose the school from which you have most representation in your program site. Visit this link to find the school profile: https://gems.opi.mt.gov/SitePages/DistrictInfo.aspx
What age group(s) does your program serve?
Please select all that apply.
  • High School
  • Middle School
  • Elementary
  • Pre- K
What topics are a focus of your program?
Please select all that apply.
  • Academic Support
  • Agriculture/Livestock
  • Coding
  • College and Career Readiness
  • Community Service/Service Learning
  • Gardening
  • History
  • LGBTQ-Peer Support
  • Life Skills
  • Native and Indian Education
  • Nutrition and Cooking
  • Performing Arts
  • Robotics
  • Social and Emotional Learning
  • Social Justice
  • Sports/Recreation
  • STEM/STEAM
  • Visual Arts
  • Other
Transportation
Do you provide transportation or is transportation provided within your program?
Transportation Defined
Select all that apply.
  • School district provides transportation during the school year
  • School district provides transportation during the summer
  • Local partners provide transportation during the school year
  • Local partners provide transportation during the summer
  • Parents provide transportation
  • Transportation is available for specific activities only (i.e. field trips)
  • Other
Food Provided
What food services are provided by your program?
  • Breakfast
  • Snack
  • Evening Meal/ Dinner
  • Summer Lunch
  • No Food Provided
Community Partnerships: Approximately how many community partners does your program work with throughout the year?
Community partnerships refer to the sustained, interactive relationships with varied community groups (i.e. education, civic, and business groups), that understand and contribute to the work of supporting youth.
Social Media
  • Facebook
  • Instagram
  • Twitter
  • None
Please provide your organization’s social media account names/handles:

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