Service Provider Application Name(Required)Address(Required) Street Address Address Line 2 City ZIP / Postal Code Phone(Required)Email(Required) Program Title(Required)LogoAccepted file types: jpg, gif, png, Max. file size: 12 MB.Teacher photoAccepted file types: jpg, png, Max. file size: 12 MB.Other supplemental photos Drop files here or Select files Accepted file types: jpg, png, Max. file size: 12 MB, Max. files: 3. Photos released to the course or what students will be learning may be added to include in the course description.Program Start Date(Required) MM slash DD slash YYYY Program End Date(Required) MM slash DD slash YYYY Program Start Time(Required) Hours : Minutes AM PM AM/PM Program End Time(Required) Hours : Minutes AM PM AM/PM Program Days of the Week(Required) Sundays Mondays Tuesdays Wednesdays Thursdays Fridays Saturdays Select all that applyProgram Description(Required)Minimum Capacity(Required)Maximum Capacity(Required)Cost Per Student(Required)Is transportation included?(Required) Yes, transportation is included No, participants will need their own transportation Course Type Art Sports Language - In-person group classroom Language - Virtual group classroom Language - Hybrid group classroom Language - Master-apprentice Language - Immersion program Cultural/traditional activities Academic/tutoring - STEAM-related Academic/tutoring - Homework help Academic/tutoring - Educational enrichment Academic/tutoring - Educational review Spiritual Wellness/health Life skills Camp Career/College prep Mentorships Food Distribution Subsistence Leadership development Check all that applyMaterials required for the program Computer Internet Transportation to performance site Parent involvement Check all that applyOther materials required(Optional) Cultural Group Relevancy of program Inupiaq/St. Lawrence Island Yupik Yup’ik/Cup’ik Aleutian/Unungax Alutiiq/Sugpiaq Athabascan Tlingit/Haida/Tsimshian/Eyak Multiple/Statewide Pick all that applyGrade level range of participants(Required)Number of staff(Required)Number of volunteers(Required)Mitigation plan for COVID or other disruptorsMax. file size: 50 MB.
