Project Reconnect Sign-Up Form
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Name *
Organization Name *
Organization Address *
Lead Contact Name *
Lead Contact Email *
Lead Contact Phone *
What is your organization's mission statement? *
What age group does your organization serve?
If applicable, what zip codes does your organization serve?
If applicable, what schools does your organization work with?
What is your organization's capacity to provide the requested services? *
I understand that participating organizations must comply with all MNPS Policies and Procedures. *
My organization can meet and document all insurance requirements as stated in MNPS Data Contract *
My organization's staff that will be working on this project are committed to attend a one-time training prior to the start of the Project period on Thursday, August 26th from 9am - 11am. *
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