Recommend an Evidence-Based Dropout-Prevention Program

Please complete the following questionnaire to assist the NDPC-SD in evaluating your program for our database of recommended programs.

Required *

General program information

Program Title *

Person we may contact for information about the program

First Name *

Last Name *

Organization

Address 1 *

Address 2

City *

State *

ZIP Code *

Email Address *

Work Phone *

Check all the descriptors that are applicable to the program *

Student advisory program
Support for students to attend classes and stay focused in school
Help for students with personal issues or problems
Efforts to engage students in extracurricular activities
Direct, individualized academic tutoring
Support for completing homework
Early literacy instruction
Other academic supports (e.g., learning strategies instruction, content enhancement)
Vocational education / career preparation classes
Positive behavior support program
Cognitive behavioral interventions (e.g., training in anger management, interpersonal skills, or problem solving)
Community-based work experience or school-to-work program
Smaller learning communities
Mentoring program
Alternative programs (e.g., parenting classes or on-site daycare for students' children)
Alternative school
Transition program
Credit-recovery program (e.g., on-line courseware)

Check all applicable disability categories served by the program *

Emotional disturbance
Autism
Specific learning disabilities
Orthopedic impairments
Other disability category
Disability category is irrelevant to the program - it could serve any child.

Check the level, below, at which the program operates *

Universal: primary prevention for all youth -- district-wide or school-wide (e.g., student advisory programs, school to work programs, positive behavioral supports)

Selected: prevention/intervention for at-risk youth (e.g., skill building, mentoring, school within a school)

Indicated: for high-risk youth (e.g., specific individualized behavior plans, intensive wrap-around services, Check & Connect)

Check the type of program below *

Prevention

Intervention

Re-entry

Describe the program and list its major goals and intended outcomes.

Briefly describe the theoretical basis and research evidence used in the development of the program as well as the data collected to measure program outcomes.

List and briefly describe any research or evaluation studies that have been conducted during the program implementation.

Recommend an Evidence-Based Dropout-Prevention Program

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