July 17, 2010 Shannon Walker SIA Foundation, Inc. P.O. Box 6479 Lafayette, IN 47903 Dear Ms. Walker, We write to ask the SIA Foundation’s support for the Witham Family YMCA located in the Boone County seat of Lebanon, Indiana. Your support would come through a grant of $8,715.00, which will fund the purchase of equipment for the Child Watch program. To promote our mission of putting Christian principles into practice through programs that enhance personal growth and improve health of spirit, mind, and body for all, we realize some members may need the extra support to meet those goals. The purpose of this grant is to help meet the goals of guardians/parents with small children. Often guardians/parents will forgo their own personal growth and healthy lifestyle choices such as exercising because they do not have reliable child care. The Witham Family YMCA seeks to lessen the burden of its community and members by providing a safe, reliable, child care option. A detailed description and projected costs of providing this service is included in the following proposal. We are asking you, the SIA Foundation, for support because we have similar goals for our community. We both want to improve the quality of life and meet the needs of our residents. This grant money will be used as a capital investment in the areas of health and welfare and will be used within one year of receiving funds. Please note we have included all necessary documentation required by your foundation. If further information is necessary, please contact us and we will oblige your request. Also, if you have any questions or would like to meet with us, please don’t hesitate to call or email us at ckline@tds.net. Thank you for your time and consideration of our request. Sincerely, Carrie M. Kline Volunteer Grant Writer cc: Lora Pennington Cindy Moore Volunteer Grant Writer A Proposal for Funding Child Watch Program at the Witham YMCA To the SIA Foundation Amount Requested: $ 8175.00 November 18, 2010 Or when available Carrie Kline Cindy Moore Volunteer Grant Writers Witham YMCA 1025 N. Jameson St Lebanon, IN 46052 765.482.5960 2 Table of Contents For Child Watch Program at the Witham YMCA Executive Summary ........................................................................................................................ 4 Statement of Need ........................................................................................................................... 6 Project Description ......................................................................................................................... 8 Evaluation ..................................................................................................................................... 11 Sustainability ................................................................................................................................ 11 Organization Information ............................................................................................................. 12 Conclusion .................................................................................................................................... 14 Appendices.................................................................................................................................... 15 3 Executive Summary The Witham YMCA is requesting a capital grant to purchase the necessary equipment to furnish the Child Watch room at a state of the art facility that is currently being constructed. The Boone County YMCA has been serving Boone County for more than forty years without a central facility to house its programs and services. The population in Boone County has grown over the past decade, resulting in more residents and particularly more families in need of services offered by the YMCA. The Boone County YMCA established a partnership with Witham Hospital to build a new facility on the Witham Hospital campus. The name of Witham YMCA will be used throughout the proposal as the new name for the Boone County YMCA. Construction began in October, 2009 for a 35,000 sq. ft. facility that is anticipated to be completed by November, 2010. The new facility is designed to serve 4,000-5,000 people within the first year, and more in subsequent years which will impact the health and wellness of the community in a positive manner. Due to the large number of families in Boone County, many of the programs offered by the YMCA are designed for children and youth. The need for childcare for families while using the YMCA facilities was made evident through surveying our existing members. Most families with young children are not able to exercise on a regular basis due to limited childcare options for their children. The cost of childcare is also prohibitive for many families for activities other than work. One of the services provided by the YMCA is the Child Watch program, which is a child care program for families with young children. The Child Watch program offers free child care in a safe, educational environment while parents participate in individual or group exercise programs within the facility. Parents can also utilize Child Watch while away from the facility for up to two hours per day for a small additional fee. The Child Watch program has its own 965 square foot room within the YMCA. The request of this proposal is for funding for the equipment to furnish this room. The room will include many items that will provide a fun, yet educational environment for children ages 6 weeks to 10 years. Age appropriate toys and equipment are needed prior to the 4 opening of the facility in November, 2010. Having various accessories and activities available to children in the center will encourage learning, social interaction, and new discoveries within a safe environment. The Child Watch room will begin serving the community as soon as the YMCA is available for public use. The total amount requested to fund this proposal is $8175.00. An itemized list of equipment will be included in the appendices of this proposal. Those impacted most by this project will be the children and parents that utilize the Child Watch program. Children will experience stimulating play experiences and social interaction with other children. The child care program will allow parents time to enhance their personal growth by improving their own health of spirit, mind, and body. 5 Witham Family YMCA Child Watch Program Statement of Need For more than forty years the independent Boone County YMCA has been changing lives and strengthening our community by promoting values like caring, honesty, and responsibility. Recently the Boone County YMCA joined forces with the YMCA of Greater Indianapolis. This has allowed greater potential and support for fundraising efforts for the building of the facility. An ongoing partnership will provide support and resources to the now called Witham Family YMCA, strengthening its ability to serve the residents of the community. Currently, the Witham Family YMCA provides programs and services for 1,000- 2,000 people, utilizing various facilities throughout the community. Coordinating and overseeing programs in various locations has restricted the number and types of programs we have been able to offer. The need to provide services to more people within the community has prompted the building of a new facility that will serve all residents of Boone County. One central location is needed to provide the most comprehensive programming in the most efficient manner. As of the census of 2000, there were 46,107 people, 17,081 households, and 12,810 families living in Boone County. The population density was 109 people per square mile. The 2008 population density was 133 per square mile. The total number of housing units in 2008 was estimated to be 22,148. By 2009, the population had grown to 56,287 which is an increase of 22.1%. The projected growth over the next five years, as determined by the U.S. Census Bureau, is that the census will be 62, 958 by 2015. The households with parents who are married with children comprise 31.4% of the households. Those married without children comprise 33.1%, single parent households 6.6%, and people living alone 21.2%. Owner occupied homes account for 75% of the housing units in Boone County with a median value of $131,000. Renter occupied units make up 11% with a median rent of $545, based on U.S. Census Bureau statistics from 2000. 1 1 Information found on World Wide Web on June 14, 2010. http://www.stats.indiana.edu/profiles.asp?scope... 6 The rapid growth in the past ten years and projected growth demonstrates a growing need for community services. The age span of the population creates a need for programs that meet the need of all age groups, from babies to seniors. The YMCA has a strong history of providing ageappropriate, educational and enriching programming to the communities it serves. The YMCA Board of Directors and staff established a unique partnership with Witham Hospital to build a facility that would meet the medical and health needs of the community. The partnership will allow the YMCA and Witham Hospital to create more opportunities to serve more people in one convenient and safe location. Construction began in October 2009 on a 35,000 sq. ft. YMCA facility on the Witham Hospital campus. The new facility will reflect the partnership with the hospital and will be named the Witham Family YMCA. It is a state of the art facility that will serve all residents of Boone County. The facility will be a place for people to pursue healthier lifestyles by accessing the most modern workout equipment, nutrition counseling and supportive staff. The synergy of programs and services will give both organizations many new opportunities to serve more people than either could on their own. It will also provide ways to save the community money by reducing overlapping services while sharing space and operational costs. The YMCA provides young people with opportunities to explore their options, reach their potential, develop a positive self-image, appreciate good health, adopt a positive value system and grow spiritually. The YMCA is committed to being open and accessible to all serving men, women, and children of all ages, faiths, background, abilities and income levels helps the YMCA realize its mission: To put Christian principles into practice through programs that build healthy spirit, mind and body for all. One of the needs within the YMCA is the need for child care while parents are exercising or participating in a program within the facility. The Child Watch was designed to provide a safe, interactive play area for young children ages 6 wks-10 yrs. This program is offered to parents at no extra cost for up to two hours while they work out. Parents can also utilize Child Watch for up to two hours a day while they are away from the facility for a nominal fee. 7 Project Description Research has shown that exercise is an important step in a healthy lifestyle. However, occasionally families will not participate in this important step because of the lack of adequate child care. The YMCA will provide the solution for parents that lack adequate childcare for their children while they exercise or run errands outside of the YMCA. The Child Watch room is a 965 square foot facility. This facility will include many items that will provide the safe and fun environment for the children. The kinds of equipment in a child watch center can play a crucial role in the development of a child. Having various accessories in the center can fuel discoveries and open doors to more learning and fun. An itemized but not exclusive description of equipment is described below. The Child Watch room will begin serving others as soon as the YMCA is available for public use. Furniture Mobile storage unit with shelves Information board Locking Cabinets Pick a book stand Cribs (2) Child table and chairs Toys/Entertainment Tracks and trains Child rocking chair Toy garage with cars/trucks Adult rocking chair Workbench with tools Infant swing Kitchen center Diaper pail (2) Writing center Facilities/Safety First Aid Kit Coat Hooks Clocks (2) Phone Trash can Puppets Dolls/cradles/strollers/etc. Musical instruments CD player with assorted music Books for many ages Miscellaneous items Information about the child care benefit will be released within various media outlets. It will be included in all seasonal program guides and new member packets. Flyers will be available describing the services offered outside of the Child Watch area, located in high traffic areas. 8 Local advertising whether on the radio, TV, internet, mailings or newspapers will also provide information about the Child Watch program. All staff and volunteers will be trained to answer basic questions about the service. Project Timeline 1. Continue to release statements of progress in the community about the opening of the new facility, Witham Family YMCA. Promote the benefits of having a YMCA in their community and how they can help. 2. Current employees have been assigned to research and purchase the equipment needed to create the Child Watch area. The Witham Family YMCA has a line of credit with Chase Bank. 3. A tentative scheduled Grand Opening Date is November 18, 2010. Staffing Staffing for the Child Watch Area at Witham Family has not been completely implemented at this time. Below are tentative positions. Positions are currently open to Greater Indianapolis YMCA employees. The positions will be open to the general public in September 2010. The number of volunteers/employees for each position will be determined at a later date. Employee wages are paid out of the YMCA’s general fund. Volunteers-Child Watch Aides Play games and read with children. All volunteers must complete the Volunteer Contact Form to be connected with the Volunteer Champion at the YMCA branch. Child Care Aide - Child Watch Assist Child Watch Team Lead with daily activities, which include interacting with children, parents, & staff, maintaining feeding/diapering schedules following all safety guidelines for YMCA assist with transition to next shift. Applicants must be at least 16 years old and have experience working with children. Child Care 9 Aides must have a high regard for safety, basic knowledge of child development, good communication skills and the ability to obtain required YMCA training (CPR & First Aid certifications, Child Abuse Prevention, Safety & Risk Management and YMCA Child Care/Youth Development training) and TB Test. Days and times may vary. Day/Evening Lead Child Watch Attendant Child Care - Part Time Must enjoy working with children and is dedicated to making a difference in their lives by being a good role model. Attendants should be dedicated and hardworking individuals, who are problem solvers, have good communication skills, have a sense of humor and enjoy being a part of a team. Flexibly and reliability and willing to work weekends is a must. Attendants may be working in our Parents’ Night Out program. Lead Attendants must be at least 18 years of age with a high school diploma. At least two years of experience working with children. They will ensure that proper procedures are being followed in all areas of Child Watch. They also act as point of contact for parents and staff for a specific shift, handling any problems or issues that may arise in a positive and professional manner. Oversees and monitors Child Watch staff during specific time shift and ensures that staff are monitoring and interacting with children at an acceptable and appropriate level. Communication to the Program Coordinator on all Child Watch issues on a regular basis. All Attendantes must have a high regard for safety, basic knowledge of child development, good communication skills and the ability to obtain required YMCA training (CPR & First Aid certifications, Child Abuse Prevention, Safety & Risk Management and YMCA Child Care/Youth Development training) and TB Test. Program Coordinator- Child Watch Under the direction and supervision of the Youth and Family Life Director, the Program Coordinator is responsible for the staff and children in Child Watch, ensuring a healthy, safe and loving environment. The Coordinator will demonstrate Caring, Honesty, Respect and Responsibility while providing for children’s social, physical, spiritual and mental well-being and will interact positively with parents to develop a trusting relationship. 10 Must be at least 21 years old, have a high school diploma or its equivalent and have at least one year of experience working directly with children, preferably in an early childhood setting (2-3 years preferred). They must have an understanding of the stages of child development, meeting the needs of the children using the Child Watch area and experience in supervising staff and handling conflict situations with members and staff. Capability of establishing and maintaining positive relationships with staff, members, program participants, and with the general public is also required. Must have the ability to obtain CPR and First Aid certifications, Child Abuse Prevention training, Safety and Risk Management Training, New Employee Orientation and other training required for YMCA youth workers. Days and times may vary. 2 Evaluation The Child Watch program will be evaluated by various means. 1. Success will be indicated by the number of members that use the service. If 50% of the members that fall into the demographic criteria use the Child Watch., it will be considered a success. The number of families with age appropriate children will be obtained from the Membership Database. 2. Comment Cards/Drop Off Box are available to all members of the YMCA. These are general comment cards for the whole campus. 3. Child Watch evaluations are sent to a random group of parents that utilize the Child Watch service on a monthly basis. Central Office then compiles and summarizes results. A summary report is then put together and released to employees. See Appendix D. 4. Both Child Watch employees/volunteers will be encouraged to submit their ideas to the Program Coordinator for evaluation. Sustainability This grant will enable the Witham Family YMCA to purchase equipment needed for the startup of the Child Watch Program. After the initial start up costs, the costs of maintaining the facility 2 Information found on World Wide Web on June 17, 2010. http://www.indymca.org/jobs/positiondetail.asp?id=2876 11 should be minimal. Income to support the Child Watch will come from the nominal fee that is charged to parent members when they leave the premises. Income to support the program will also come from the organizational wide annual fundraising drive, member fees, and any additional fundraising events to help sustain the program. One specific fundraising event planned is the hosting of a toy party with Discovery Toys. This party will be open to the public. Attendees will be given the opportunity to buy toys for their own household or buy a toy as a donation to the YMCA. A percentage of the sales from this party will go to the Child Watch Program of the Witham Family YMCA. Those proceeds will be used to buy any equipment as needed. If successful, this fundraiser may be help on an annual basis. Organization Information The organization known as the YMCA originated in London, England in 1844, and came to Indiana in 1854. The organization has continued to maintain a rich tradition of building “strong kids, strong families and strong communities”. Throughout the Indianapolis area, our twelve YMCA branches serve more than 185,000 people from diverse communities--providing over $7 million in scholarships, program subsidies, and underwritten programs among low-income communities. We want to do more than serve the people in our community—we want to help them thrive. Our mission is to put Christian principles into practice through programs that enhance personal growth and improve health of spirit, mind, and body for all. The YMCA provides young people with opportunities to explore their options, reach their potential, develop a positive self-image, appreciate good health, adopt a positive value system and grow spiritually. The YMCA is committed to being open and accessible to all. Serving men, women, and children of all ages, faiths, backgrounds, abilities and income levels helps the YMCA realize its mission: To put Christian principles into practice through programs that build healthy spirit, mind and body for all. The YMCA adds lasting value to the lives of children and families by helping people begin and maintain healthy lifestyles, providing a positive, safe place for children and helping teens 12 develop leadership skills and succeed in school. We teach character-building values to youth and provide a place that strengthens families. Programs for seniors enrich their social and physical well-being. The programs offered include all age groups, which results in the YMCA enriching the lives of individuals, families, and the community. The Boone County YMCA has been in existence for forty years, and has operated its programs without a central facility. It is a not-for-profit 501c3 community service organization. The YMCA has provided programs and services for more than 1,000 people each year utilizing various facilities throughout the community. Most recently, the Boone County YMCA has joined the YMCA of Greater Indianapolis Association which has allowed us to share resources and strengthen our position in Boone County. The association has also provided fundraising initiatives and support to help us realize our goal of a YMCA facility in Boone County. It is projected that the new YMCA will serve 4,000 to 5,000 people in its first year of operation. The YMCA has formed a unique partnership with Witham Hospital and the new facility that is in construction is located on the Witham medical complex. Since the facility will be utilized by both organizations, the name of Witham YMCA was chosen. A new name for a new facility seemed appropriate, and the choice ties it to the community, giving name recognition. The Witham YMCA is governed by a Board of Directors representing the diversity of the community. See Appendix C for a detailed list of the board members. Board members are chosen by their talents and their desire to fulfill the YMCA mission. An application is completed, and they are interviewed and voted on at the board meetings. The board members contribute through time, talents, and in financial ways. They are asked to attend at least 70% of the board meetings and to be active on a committee. They participate in all campaigns and in special events as they are able. The staff leadership team is composed of an executive director, two program coordinators, and one program director. The executive director, Lora Pennington, oversees the current programs and services offered by the YMCA and is actively involved in the decision-making for the construction of the new facility. She is working closely with the builders to determine the budget 13 based on the needs of the programs to be offered. The program director oversees all programs currently offered and is forecasting what services will be added when the new facility opens. The two coordinators provide day to day support for the executive director and for members, providing information and enrolling members. The volunteers are a vital part of the staffing mix and are utilized in many programs. The summer camps have volunteers assisting with many activities and providing hands-on interaction with the campers. These volunteers are adults and older youth who have received training in working with younger children. Volunteers can offer their time on a regular basis or for special events. The variety of skills offered by the volunteer group has enhanced the quality of the programs offered. Volunteers also help with fund-raising events, membership drives, and donations. We have a well-established core of volunteers who are actively involved in investing in the future of Boone County. Conclusion The Witham Family YMCA in Lebanon, Indiana is a resource that will enhance personal growth and improve the health and spirit of all those that participate in its programs. There is a commitment to accomplish a relationship building atmosphere. Those relationships are based on the core values of caring, honesty, respect and responsibility. To give the families with young children the same opportunity to build those relationships, a Child Watch Center will be constructed within the YMCA. This center will provide child care for children up to the age of ten years old while their parent(s) participate in the relationship building activities. These activities are not only for themselves, but also as building block for a community. Witham Family YMCA has been very proactive in raising the funds needed to build a new facility and we have secured funding through Chase Bank to cover additional. The SIA Foundation Grant for $8175.00 will lessen the burden of the loans and enable us to provide more services to our members and the community. We appreciate your time and request your support for our children and the Child Watch Center. 14 Appendices For Child Watch Program at the Witham YMCA 15 Item Witham Family YMCA of Greater Indianapolis Costs Related to Child Watch Center Retail Cost # of Units Appendix A Projected Total Furniture Mobile storage unit with shelves Pick a book stand Cribs Childs table and chairs TV/DVD Child rocking chair Adult rocking chair Infant swing High Chairs Diaper Pail $400 1 $400.00 $250 1 $250.00 $200 2 $400.00 $150 2 $300.00 $1,000 1 $1,000.00 $100 3 $300.00 $300 2 $600.00 $37.50 2 $75.00 $150 2 $300.00 $12.50 2 $25.00 $30 1 $30.00 $500 1 $500.00 $150 2 $300.00 $20 1 $20.00 $100 1 $100.00 $150 1 $150.00 $350 1 $350.00 $375 1 $375.00 $450 1 $450.00 $150 1 $150.00 $100 3 $300.00 $400 1 $400.00 $300 1 $300.00 $350 1 $350.00 $250 1 $250.00 $500 1 $500.00 $8,175.00 Facilities/Safety First Aid Kit Information board Locking Cabinets Trash Can Toys/Entertainment Tracks and trains Toy garage with cars/trucks Workbench with tools Kitchen center Writing center Puppets Art Station Dolls/cradles/strollers/etc. Musical instruments CD player with assorted music Books for many ages Miscellaneous items Total 16 Appendix B 17 Appendix C 2010 Witham Family YMCA Board Members Committee # Name Chair Company Address 1 City Zip 4607 1 4605 2 4605 2 4605 2 4605 2 4605 2 4605 2 4614 7 4605 2 4605 2 4605 2 (765) 3252494 (765) 4850587 (765) 4820462 4605 2 4605 2 (765) 4827784 (765) 4829280 Farmer's Bank 3024 W. Blubaugh Avenue Thorntow n 2 Baird, Yvonne Bennington, Jerry Witham Hospital 2421 Golfside Drive Lebanon Finance Christian Mission Building and Grounds 3 Boatright, Jack Financial - Retired 2324 Elmwood Drive Lebanon 4 Bradley, Pam Boone REMC 920 Jackson St Lebanon 5 Brand, John BFS Engineering 129 Ulen Blvd. Lebanon Executive Building and Grounds 6 Burtron, Michael Jackson-McCormick Ins. 2025 Elizaville Road Lebanon 7 Davenport, Joe Sales Exec. - Retired 2946 S. 200 E. Progam 8 Emmert, Abby Western Boone-Student 5056 W. 300 S. Lebanon Jamestow n Finance Honan, Paul Honan Eye Care 202 East Drive Lebanon Progam Board Development 9 1 0 1 1 Lebanon City Police 903 Glendale Drive Lebanon Isenhower, Pat Witham Health Services 4860 E. 100 N. Lebanon Finance/Emeritu s Financial Development 1 2 1 3 Kruse, Paul (Past -President) Meyer, Mary Francis Parr, Richey, Obremskey, & Morton, Attorneys 628 North Lebanon Street Lebanon 104 Ulen Blvd. Lebanon Financial Development Building and Grounds 18 1 Hood, Scott Chair Chair Chair - E Chair of Fundraisin Home Phone (765) 4826007 (765) 4824041 (765) 4839551 (765) 6765161 (765) 4823944 (765) 4820692 (765) 4823939 g Financial Development Building and Grounds Financial Development Board Development Board Development Finance/Executiv e Board Development 1 4 1 5 1 6 1 7 1 8 1 9 2 0 Board Development 2 1 2 2 2 3 Finance Program Financial Development 19 2 4 Ameritech - Retired 245 S. Murifield Circle Lebanon Veternarian- Retired 215 Essex Drive Lebanon Morton Farms Principal, Lebanon High School 2645 E. SR 47 Lebanon 2347 Ulen Overlook Western Boone - Reitred 705 S. Pearl Street Lebanon Thorntow n Kramer Lumber 219 East Drive Lebanon Samson, Casey Student-LHS 411 N Jameson St Lebanon Schaller, Heather McConnell, Anna Remax 2323 Elmwood Drive 115 N Muirfield Circle Lebanon 4799 W 200 S 2205 Terrace Lane Milburn, Allen Chair of SKC Miller, Devon Morton, George Chair of CC O'Rourke, Kevin Chair Parker, Larry Ransom, Mark (Board Chair) Chair CPA, Katz,Sapper, Miller Teacher, New Hope Church Dale, Elizabeth Taylor, Jocelyn Co-Chair of Fundraisin g Teacher, Harney Elementary 4605 2 4605 2 4605 2 4605 2 4607 1 4605 2 4605 2 (765) 4827212 (765) 3350163 (765) 3252615 (765) 4831587 (765) 4367884 (765) 4827155 (765) 4852224 Lebanon 4605 2 4605 2 4605 2 Lebanon 4605 2 (765) 4831936 Lebanon 765-482-1235 765-676-5525 YMCA Child Watch Parent Survey 3 Appendix D 2010 Please take a few minutes to answer the questions below. Your answers are anonymous and will be used to help us improve your child's program. Thank you for your cooperation. 1. Overall, how would you rate the YMCA child care program? Please check only one box. □ Excellent □ Good □ Fair □ Poor 2. How would you rate the program on each of the following? Good Fair Poor Not applicable or don't know □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ Planned activities (such as arts and crafts, games, interest centers) Discipline practices □ □ □ □ □ □ □ □ □ □ Opportunity for unstructured play □ □ □ □ □ Facilities Safety and security Cleanliness Convenience of location Supplies/toys/games Play equipment □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ Excellent Staff Overall caregiver quality Staff warmth and friendliness Staff communication with parents Staff communication with children Program General Meals/snacks Affordability Registration/enrollment process Written information about the program or activities 3. Does your child appear to be happy at the center? □ Always □ Usually 3 □ Sometimes □ Never Modified from original found at www.clevelandymca.org/childcare/2008SchoolAgeChildCareParentSurvey.doc on July 12, 2010. 20 4. Please indicate how much you feel the YMCA child care program has helped your child: Learn to get along with others Learn to appreciate other cultures Learn to appreciate similarities and differences in others Understanding the core values of the YMCA (Caring, Honesty, Respect, Responsibility) Learn to follow rules (such as putting away toys) A lot □ Somewhat □ A little □ Not at all □ Not applicable or don't know □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ 5. Does your participation in this program make you feel confident that your child is in a safe, supportive and nurturing environment? □ A lot □ Somewhat □ A little □ Not at all □ Don't know/not applicable 6. Does your participation in this program enable you to exercise without worrying about what your child is doing? □ A lot □ Somewhat □ A little □ Not at all □ Don't know/not applicable 7. How long has your child been with the YMCA child watch program? □ Less than 1 year □ 1 year □ 2 years □ 3-5 years 8. How did you first hear about the child watch program? (check one only) □ School □ Telephone book □ Other □ Mail □ YMCA staff 9. Why did you choose this program? □ Convenience □ Had heard it was good □ Fees 10. Would you recommend this program to other parents? □ Other □ Yes 11. Have you received information on other YMCA programs available? 12. Do you or your children participate in any other YMCA programs? □ Yes □ No If yes, which program(s)?_______________________________ 13. Are you □ Single, divorced, widowed 14. How old is your 21 □ Married □ No □ Yes □ Uncertain □ No child? 15. Is your child □ Male □ Female 16. The Y is committed to serving people regardless of their ability to pay. We need to know whether we are reaching all income levels. Could you please indicate your total annual household income, before taxes? (optional) □ $0 - $9.999 □ $15,000 - $19,999 □ $30,000 or more □ $10,000 - $14,999 □ $20,000 - $29,999 17. The Y is committed to reaching out to all races and ethnicities. Could you please indicate your race or ethnicity? (optional) □ American Indian or Alaskan Native □ Black or African American □ Caucasian/White □ Asian or Pacific Islander □ Hispanic/Latino □ Other 18. Please share with us any suggestions for improvement or additional comments you might have. __________________________________________________________________________________________ Please return your completed survey to your child’s center or mail to your local YMCA 22