Boost! Agency Profile

We thank you in advance for your interest in partnering with Boost! to help ensure that New Haven students are ready and available to learn and succeed.

United Way of Greater New Haven, City of New Haven Youth Department, Citywide Youth Coalition, New Haven Public Schools, and the New Haven Board of Aldermen are interested in conducting a Joint Youth Inventory of family and youth serving organizations to:

Gain a greater understanding of our community's capacity to provide quality services to families and youth in New Haven and
Distribute this information to constituents (through New Haven Youth Map, the Boost! Directory and more).

In an effort to reduce duplication of effort (on our end and yours!) we have joined together in a common effort to collect relevant and up-to-date information.

Please note: once you have completed this form, you must click on Program Profile to complete this process for the Joint Youth Inventory.

Sincerely,

The Boost! Team

If you have any questions about Boost! and the Joint Youth Inventory, please contact:

Tirzah Kemp

Boost! Coordinator for Community Partnerships

United Way of Greater New Haven

tkemp@uwgnh.org

(203) 691-4206

General Information

Name of Organization *

Address *

Phone number *

Fax

Website *

Contact Name *

Contact Title *

Contact Email *

Is the organization a 501c3? *

Yes

Year of Incorporation

Annual Operating Budget

Description

Mission Statement *

Please provide a brief description of your organization [200 word limit] *

Please provide a brief description of your organization/group's capacity and/or expertise working with schools [150 word limit] *

Management & Governance

Executive Director/CEO Name *

Number of Full Time Staff *

Number of Part Time Staff *

Number of Volunteers *

Board of Directors Chair

Board Members

Funding Sources

% Federal *

% State *

% Local *

% Philanthropic *

% Private *

% other *

United Way of Greater New Haven

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