Project Exploration Program Partner Interest Form
Please complete if you are interested in Project Exploration providing an after school, spring break or summer program at your school or community.
Email address *
PROGRAM PARTNER INFORMATION
The following form will ask a series of questions to determine needs, available resources, and vision of partnership.
School/Organization Name *
What is your student enrollment? *
Required
Please provide general demographic information about enrolled students (e.g. age, race, gender)
Address *
City, State Zip Code *
Phone Number *
Website *
PROGRAM PARTNER PRIMARY CONTACT INFORMATION
Primary Contact Name *
Primary Contact Title *
Primary Contact Phone Number *
Primary Contact Email Address *
PROGRAM TYPE
Desired Program Type *
Required
Program Level *
Required
Program Target *
Required
Day of Operation (only for afterschool programs) *
Required
Please share why you are interested in partnering with Project Exploration, and what are your goals. *
Submit
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