New Community Partner Interest Application
Ready to become a community partner? To begin the application process please answer the below questions on the following form. Community Partners will be contacted within 2-3 business days via email with the next steps in the Community Partner application process. This application is for service only. If you offer a product or curriculum, please contact
sarchibald@viedu.org
.
Community Partner Application Process: The first step is to complete this application thoroughly. Your response will be reviewed and processed in 2-3 business days. If you qualify, we will send you the community partner contract via docusign.
Parents and Families: This survey is for ORGANIZATIONS/COMMUNITY PARTNERS to fill out. If you would like to suggest a Community Partner, please email their contact information to
vendorsupport@viedu.org
.
If you have any questions about becoming a Community Partner, please email
vendorsupport@viedu.org
.
*Due to COVID-19, at this time, we are only approving eVouchers for virtual services. New Community Partners who offer in person services are welcome to submit an interest form and start the application process. However, Community Partners who offer in person services exclusively will be activated at a later date.
* Required
Name of Business
*
Please provide the name of your business. This should agree to Line 1 of your W9. If you are a sole prop., please use your first and last name.
Your answer
Name of Contact
*
Please provide the name of the owner, director, or the primary point of contact. Please include their first and last name.
Your answer
Email Address
*
Please provide the email address of the owner, director, or the primary point of contact. Once reviewed and approved, the Community Partner Contract will be sent to this email address.
Your answer
Address of Organization- Where Services are rendered.
*
Your answer
Please provide the phone number of the Organization
*
Please use the format (123) 456-7891
Your answer
Please select the primary county you serve.
*
Amador
Contra Costa
El Dorado
Placer
Sacramento
San Joaquin
Solano
Sutter
Yolo
Online
Other: Please note that our students are only located in the above counties
Please provide a detailed description of the services you provide.
*
Your answer
Please provide, if available, your business website.
Your answer
Are you at least 18 years of age
*
Yes
No
Please list your qualifications to serve Visions In Education's students ( ie years of experience, certifications, and/or degrees).
*
Your answer
Do you have any employees, sub contractors, or volunteers?
*
Yes
No
Visions in Education requires all Community Partners to provide proof of Live Scan. Please review the below requirement prior to submitting your interest form.
*
#1 Live Scan Clearance: If you are a sole proprietor with NO employees, contractor, and volunteers (which includes relatives), you will be Live Scanned using Visions' Live Scan form. If you have employees, contractors, and volunteers, you are responsible for their Live Scan and must show proof of a DOJ issued COR letter.
I have read the Live Scan Requirements. If I qualify to be a Community Partner, I understand that I will need to upload proof when I complete the Community Partner contract.
Visions in Education requires all Community Partners to provide proof of liability insurance. Please review the below requirement prior to submitting your interest form.
*
You are required to show proof of liability insurance (Certificate of Insurance). The policy should include Visions in Education to be a Certificate Holder and an Additional Insured. The policy should also carry a $1 million per occurrence liability coverage
I have read the Liability Insurance Requirement. If I qualify to be a Community Partner, I understand that I will need to upload proof when I complete the Community Partner contract.
Visions in Education requires all Community Partners to provide proof of business legitimization. Please review the below requirement prior to submitting your interest form.
*
Community Partner's will be required to provide one of the following items with their contract. Business License {preferred} -or-Fictitious Business Name Statement -or-Form 1040 Schedule C (For Sole Props or Single Member LLCs ONLY) -or-Form W9 (For Corporations, Non Profits, or Multi Member LLC/Partnerships ONLY)
I have read the Business Legitimization Requirements. If I qualify to be a Community Partner, I understand that I will need to upload proof when I complete the Community Partner contract.
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