Chicago STEM Co-op Member Profile Survey - Chicago STEM Pathways Cooperative

Your Information

Name(Required)

First Last

Email(Required)

Phone(Required)

Title

Organization Profile Information

This section is intended to allow you to share information on your organization publicly on the STEM Co-op Member Directory on the STEM Co-op Website (chicagostempathways.org).

Organization Name(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Website(Required)

Facebook Handle

Twitter Handle

Instagram Handle

LinkedIn Handle

TikTok Handle

Contact Name (Public)

First Last

Organization or General Contact Email (Public)

What best describes your organization type?(Required)

Business/Corporation

Foundation/Funder

Library

School

City Agency not Otherwise Captured

Museum/STEM Institution

College/University

Community-Based Organization

Other

Other(Required)

Is your organization a direct-service provider?(Required)

Yes

Unsure

Does your organization provide direct service to young people?(Required)

Yes

Unsure

What age group(s) do you serve?(Required)

What Chicago communities did you served this academic year and/or do you presently serve?(Required)

Please provide your mission statement(Required)

Please provide a brief description of your organization and its core work(Required)

Please share any specific resources you believe may be helpful for STEM stakeholders

Please include links, as appropriate

Please share a high quality version of your logo(Required)

Max. file size: 128 MB.

Share up to two photos you wish to include on your profile

Drop files here or

Max. file size: 128 MB.

Other General Information

This section is intended to allow us to understand your organization's needs and how the STEM Co-op and its members can best serve your organization and partner in service to Chicago youth.

How does your organization prioritize equity in the work you do?(Required)

With what types of organizations has yours been most successful in partnering?(Required)

Businesses/Corporations

Foundations/Funders

Libraries

Schools

Parks

City Agencies

Museums/STEM Institutions

Colleges/Universities

Community-Based Organizations

Please choose the types of organzations with whom you are most interested in and believe you have the capacity to partner in the next year?(Required)

Businesses/Corporations

Foundations/Funders

Libraries

Schools

Parks

City Agencies

Museums/STEM Institutions

Colleges/Unversities

Community-Based Organizations

How is your organization actively involved in or how has it supported access to STEM in the past?(Required)

What do you hope to gain from being a member of the Chicago STEM Pathways Cooperative?(Required)

What resources are you most interested in receiving throught the Chicago STEM Pathways Cooperative and its members?(Required)

Other

Additional Contacts

Are there additional contacts from your organization who you would like to ensure receives communitions from the Chicago STEM Pathways Cooperative?(Required)

Yes

Additional Organization Contacts(Required)

Full Name

Title

Are there additional organizations you think should complete this survey and participate in the Chicago STEM Pathways Cooperative, its meetings and/or initiatives?(Required)

Yes

External Organization Contacts

Full Name

Affiliation

These individuals will automatically receive one automated email inviting them to complete the survey.

Promotional Opportunity with My CHI. My Future.

Is there summer programming your organization is leading that you want featured on the My CHI. My Future. App so young people can connect with you directly?(Required)

Yes

Please provide a brief description of the opportunity, including any relevant details (e.g. cost, age groups, location, important dates, times, topics, etc.)(Required)

Optional Field

Is there anything else you want us to know?