Unaccompanied Children Service Providers Workshop Registration
This form will be used to secure your spot at the Unaccompanied Children Service Providers Workshop at Catholic Charities Immigration and Refugee Services office at 2505 Maine Avenue in Metairie, on September 2, 2015. The form includes simple information about your services so that we can start the mapping work together in advance and hit the ground running.

To save time and avoid duplication, please submit only one registration form per organization, including all of the essential stakeholders from your organization who will participate.
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Organization Name *
Participant 1 Name: *
Participant 1 Title: *
Participant 1 Email Address: *
Participant 2 Name:
Participant 2 Title:
Participant 2 Email Address:
Participant 3 Name:
Participant 3 Title:
Participant 3 Email Address:
Additional Participants (if any) Names, Titles, Email Addresses
Organization Address: *
Main Line Phone: *
Unaccompanied Children Provider Contact Phone: *
Direct line for someone who can take Unaccompanied Children referrals (for service providers only- not to be distributed to clients)
Office Days & Hours: *
i.e. M-F, 9-5
How many staff are dedicated to Services for Unaccompanied Children? *
What is the overall capacity of staff to serve unaccompanied children? *
i.e. How many children can you serve?
Is your organization at full capacity? *
Languages spoken by staff: *
Required
Cost of Services *
Please select all that apply
Required
If your organization provides multiple services at different cost options, please explain.
Requirements for Access to Service *
i.e. age and gender requirements if any, documentation needs, immigration status, etc.
Required
Please describe in detail any requirements for access to service.
i.e. age and gender requirements if any, documentation needs, immigration status, etc.
Parishes served:
Please select all that apply.
Area(s) of Expertise *
Please select all that apply
Required
What do you find most encouraging about Service Provision to Unaccompanied Children in New Orleans?
What do you find most frustrating about Service Provision to Unaccompanied Children in New Orleans?
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