OMBrespones.Exhibit3.a.010807_wjb

TABLE 1 (continued)

questions on grantee characteristics

telephone interivew for the head start oral health initiative evaluation: grantee name and location

Information to Confirm from Grantee’s Oral Health Initiative Proposal
Grantee address	THIS SECTION WILL BE FILLED WITH
Grantee telephone number	INFORMATION FROM EACH GRANTEE’S
Primary contact for the Oral Health Initiative	PROPOSAL
Primary contact’s job title
Primary contact’s email address
Programs operated by grantee (Head Start, Early Head Start, Migrant/Seasonal Head Start)
Service options offered (center based, home based, combination)
Number of Head Start centers grantee operates
Operating schedule
Other Agency Background Information
Main programs operated by grantee (other than Head Start)
Number of agency staff
Approximate number of families served annually
Number of years agency has been in operation
Number of years agency has provided Head Start, Early Head Start, and/or Migrant/Seasonal Head Start services

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