Are there any existing literacy programs in your area? Yes No Unsure

Are you interested in starting a program as an individual, or is your organization interested in adding literacy to its services? Individual Organization

What kind of programs are you interested in starting? Please check all that apply:

• Basic Literacy for native speakers
• English for Speakers of Other Languages (ESOL)
• Family Literacy
• Workplace Literacy
• Other (please explain):

Independent Agency-based

How many years has your agency been in existence?

How many adult learners and tutors do you serve each year? 50 or fewer 51-100 101-150 151-250 251-350 351-450 451-500 501+

How many employees, full time and part time, do you employ?

What is your annual budget? $25,000 or less $26,000 to 50,000 $51,000 to 75,000 $76,000 to 100,000 $101,000 to 150,000 $151,000 to 200,000 $201,000 to 300,000 $301,000 to 400,000 $401,000 to 500,000 $501,000 or greater

Please check which items you are interested in learning more about (check all that apply):

• Affiliation and Accreditation Standards
• Board Development
• Program Management
• Tutor Training
• Other (specify)

Comments: