ChildBuilders' Data Request 2022-2023

Presenter First Name *

Presenter Last Name *

Presenter Email *

Name of School *

School District or Organization *

School Zip Code *

Did you present ChildBuilders' Programs this year? *

Yes
No

Do you plan to present ChildBuilders' Programs next year?.... *

Yes
No

If you did NOT present this year, please let us know what barriers occurred for you. How can we support you better next year? Then, skip to the end of this form and click Submit.

Explanation

If you did present ChildBuilders' programs this year, please complete the remaining questions. For your convenience, you may submit this form multiple times throughout the year, or submit a different form for each program.

Which program(s) did you present this year?

Stand Strong • Stay Safe Early Childhood (PK-1)
Stand Strong • Stay Safe Elementary (2-5)
Build to Nurture
Parents Under Construction
Relationship Smarts PLUS
Love Notes
WHO

Stand Strong • Stay Safe - Early Childhood (4SEC)
Curriculum designed for PreK-1st Graders using stick puppets - panda, puppy, penguin, etc.
How many students did you serve through this program and what was the impact on your students?

# Students PreK (4SEC)

# Students K (4SEC)

# Students 1st (4SEC)

# Students Above 1st (4SEC)

Date of Presentations (4SEC)

After presenting, did you observe students using the skills practiced in the lessons? We encourage you to explain further in the Impact/Comments section.

Yes
No

Impact/Comments (4SEC)

How many students received Home Connections for Early Childhood?

All or Most
More than 50%
Fewer than 50%
None

Stand Strong • Stay Safe - Elementary (4SE)
You may have been trained in one or more of these curricula: Original Combined Curriculum 2nd-5th Grades (2018), Lower Elementary 2nd-3rd Grades (2019), or Upper Elementary 4th-5th Grades (2019). How many students did you serve through this program and what was the impact on your students?

# Students Below 2nd (4SE)

# Students 2nd-3rd (4SE)

# Students 4th-5th (4SE)

# Students Above 5th (4SE)

Date of Presentations (4SE)

After presenting 4S Elementary, did you observe students using the skills practiced in the lessons? We encourage you to explain further in the Impact/Comments section.

Yes
No

Impact/Comments (4SE)

How many students received Home Connections for Elementary?

All or Most
More than 50%
Fewer than 50%
None

Build to Nurture (B2N)
Social and Emotional learning program for PreK through Grade 1 Classrooms
How many students did you serve through this program and what was the impact on your students?

# Students PreK (B2N)

# Students K (B2N)

# Students 1st and Above (B2N)

Date of Presentations (B2N)

After presenting Build to Nurture, did you observe students using the skills practiced in the lessons? We encourage you to explain further in the Impact/Comments section.

Yes
No

Impact/Comments (B2N)

Relationship Smarts PLUS (RSP) (Formerly Love U2)
Relationship Education for Middle and High School students. You may have been trained in Relationship Smarts PLUS or Love U2.
How many students did you serve through this program and what was the impact on your students?

# Students 6th-8th (RSP)

# Students 9th-12th (RSP)

Date of Presentations (RSP)

Impact/Comments (RSP)

Love Notes (LN)
Relationship Education for Young Adults
Please tell us the total number of students you taught this program to and the total number of presentations you made. One class session equals one presentation. What was the impact of this program on your families?

# Students - Under 18 (LN)

# Students - 18-24

# Presentations (LN)

Date of Presentations (LN)

Impact/Comments (LN)

Parents Under Construction
Parenting Prep Education for Teens and Young Adults
How many students did you serve through this program and what was the impact on your students?

# Participants - High School (PUC)

# Participants - Age 18-24 (PUC)

How many of these students were currently pregnant or parenting?

After presenting PUC, did you observe participants using the skills practiced in the lessons? We encourage you to explain further in the Impact/Comments section.

Yes
No

Impact/Comments & Grade Levels

How many students received Family Connections for Parents Under Construction?

All or Most
More than 50%
Fewer than 50%
None

WHO
Personal Safety Education Program
How many students did you serve through this program and what was the impact on your students?

# Students (WHO)

Date of Presentations (WHO)

Impact/Comments (WHO)

Please share with us any other comments you have about ChildBuilders' programs. Testimonials from students, other educators, or parents are particularly valuable to our reporting.
For example, did you adapt the programs in any way? Is there something that is working particularly well for you? What would you like to see changed or improved?

Comments

The following checkbox is required to be included on this form. We make every effort to send only relevant emails to our presenters. Please contact us if you have any concerns about the type of communications you are receiving.

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ChildBuilders' Data Request 2022-2023