SHOP: Collaboration Interest Form

Thank you for your interest in collaborating with the Shelter Health Outreach Program (SHOP)! We are excited to explore potential partnerships with clubs and organizations that share our mission of promoting healthcare equity and making a positive impact in our community. Please provide us with the following information to help us understand how we can work together effectively:

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Email *

Organization/Club Name:


Contact Person:


Phone Number:

How do you envision collaborating with SHOP? Please provide details about your proposed collaboration:

-What specific outcomes or goals do you hope to achieve through this collaboration?

-How do you see this collaboration benefiting both our organizations and the community we serve?

-Are there any specific timelines or events you have in mind for this collaboration?

Is there any additional information you'd like to share or discuss regarding this collaboration inquiry?

(This is not meant to be formal!! bullet notes are perfectly fine :) )

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