NAZA-Funded Proposed Target Program Site Locations 2026-2027 (Annex 8)

Name of Organization

Programming Information

Days of Week of Afterschool Program

4 days per week5 days per week

Afterschool site plan

Community SiteSchool SiteCheck the boxes that applies to your programming site plan.

Planning summer programming?

YesNo

Planning additional summer programming at an MDHA Community Site(s)?

YesNo

ALL TARGET YOUTH NUMBERS MUST MATCH YOUR ESTIMATED

NUMBER OF YOUTH FROM YOUR PRELIMINARY BUDGET.

Afterschool Program Name

N/A if name is same as Organization.

Total Afterschool Enrollment Goal

Number must match estimated total on preliminary budget.

Name of School Site Location

Address of School Program Site

School Partnership Level

Number of youths targeted for site

Transportation needed?

YesNo

Name of Community Site Location

School or Building Name

Address of Community Program Site

Target School for Community Site

Number of youths targeted for site

3rd Party Transportation needed?

YesNo

Summer Programming Information

Summer Program Name

Total Summer Enrollment Goal

Number must match estimated total on preliminary budget.

Total Weeks of Programming

Days per Week of Summer Program

4 days per week5 days per week

Hours per Day

Programming Time Frame

Ex: 8:30am – 3:30pm

Proposed months of Summer programming

July 2026June 2027Both

July 2026 Proposed Weeks of Programming

June 2027 Proposed Weeks of Programming

Name of Summer Site Location

State Building Name (Ex. Church or Community Center name)

Summer Location address

Number of summer youth targeted for site

Count only rising 5th and 9th grade youth.

MDHA Site Location(s)

Cumberland View (Max Capacity: 20)J.C. Napier (Max Capacity: 50)John Henry Hale (Max Capacity: 30)Preston Taylor (Max Capacity: 50)Sudekum Apartments (Max Capacity: 50)

Will this be a hybrid location program?

YesNoHybrid is defined as more than one location (Virtual is not an option)

Name Secondary Summer Site Location & Address

Number of summer youth targeted for site

Count only rising 5th and 9th grade youth.

Contact Information