MNACHC Partnership & Vendor Request Form
Thank you for your interest in working with the MN Association of Community Health Centers (MNACHC)! In considering your request, we ask that you provide us with specific information about your project and your organization. This will allow us to better understand how the project or service aligns with our mission and to assess the scope of the request and our capacity to participate.
Email address *
Name *
Your answer
Title *
Your answer
Email *
Your answer
Phone *
Your answer
Organization *
Your answer
ED/CEO Name *
Your answer
Address *
Your answer
Website *
Your answer
This organization is (choose one): *
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