Section 5; View 5.15; Version 1.1

Questionnaire Response -- Organizational Information

Summit Achievement

Received April 28, 2009

Return to Summit Achievement Questionnaire Response Index

Return to Summit Achievement Questionnaire Response Face Sheet

Return to Questionnaire Response Index

Return to Summit Achievement Program Review

Questionnaire forms for organizations that want to be included

 

Note:  This is an edited version of the questionnaire submission to make it more reader friendly.  Actual submission is available at Summit Achievement Index

 Summit Achievement

  

Organizational Information

from View 5.15

3. Legal name of CompanySummit Achievement of Stow, Inc.

4. Legal Address:

69 Deer Hill Road

Stow, Maine  04037    

207.697.2020    Fax: 207.697.2021

Email: admissions@summitachievement.com

12.  List any DBA names (“Doing business as”), that is, other names by which this company is known. 

Summit Achievement 

13. State (or other jurisdiction) in which you are incorporated:

Maine

14. Are you a publicly held corporation?

No 

15.  Identify all persons and/or legal entities holding more than 5% interest, preferably in order according to the size of holding starting from the greatest to the least.  List the investors with the common name by which the investor is best known.  

 Christopher Mays, Executive Director

 Candide Kane

 Nicholas Will White, Clinical Director

 Adam Tsapis, Director of Admissions

 16: Actually in charge

Christopher Mays, Executive Director

17.  Who are the members of your governing board? 

Christopher Mays

Candide Kane

Will White

Adam Tsapis 

18. Is your organization managed by a contract manager or management company?  If “yes” please identify the contractor/company:

No

29. Please identify your Chief Executive Officer (whether or not that is the title you use). We refer to the most senior person actually functioning as a full time manager or executive, reporting to the board or to investors.

Christopher Mays    

Executive Director

69 Deer Hill Road 

Stow,  Maine 04037      

Telephone:  207.697.2020       Fax: 207.697.2021

Email: chris@summitachievement.com

 

30.  Chief Operating Officer

Margaret Lannon, Program Director

Address: Same as above

Email: margie@summitachievement.com

31.  Please identify your Chief Financial Officer

None             

32. If you are a direct service provider, please identify your principal contact person regarding new admissions or enrollments or other delivery of service.  This is the person our readers should contact if they want to purchase services from you. If you are not a direct service provider, enter “none.” 

Adam Tsapis, Admissions Director

Address: Same as above

Email: Admissions@summitachievement.com

33. Person to Contact on general business matters:

Christopher Mays, Executive Director

Address: Same as above

Email: chris@summitachievement.com

34. Please attach an organization chart of your organization

Dependence / Independence

The following responses in Section 1 of the questionnaire suggest that Summit Achievement is a totally independent entity, not controlled not owning or controlling or affiliated with any other organization of interest to FamilyLight sm

1.3  ___Yes   X  No    Are you a Parent Organization (holding company, umbrella organization)?  If you check “yes,” you have an “A number” of 3.

1.5  X Yes   ___ No    Is your organization is completely independent?  If you check “yes,” you have an “A number” of 5.  You are independent for our purposes if you are not controlled or affiliated with another organization   

 

35. Name and contact information of person responsible for accuracy of questionnaire: 

Name: Christopher Mays, Executive Director

Address: Above

Additional Corporate / Organizational information

Direct Service information

Return to Summit Achievement Questionnaire Response Index

Return to Summit Achievement Questionnaire Response Face Sheet

Return to Questionnaire Response Index

Return to Summit Achievement Program Review

Questionnaire forms for organizations that want to be included

 (c) Copyright 2009 Thomas J. Croke and Associates, Inc.  All rights reserved.   For information  regarding use of content of this website, click here.