Partnership Opportunity Request
Please fill out this form for all partnership opportunity requests.
Point of Contact: Name *
Your answer
Point of Contact: Email *
Your answer
Point of Contact: Phone Number
Your answer
County of Potential Partnership
If the county the partnership would originate in is not listed, please select "other".
Services Requested
Please check all that apply. If the service you are requesting is not listed, please select "other".
Resources Requested
Please check all that apply. If the resource you are requesting is not listed, please select "other".
Event Date(s)
Please submit potential event dates in the following format: mm/dd/yyyy. If there are several concurrent dates: mm/dd - mm/dd/yyyy.
Your answer
Event Location
Please provide the location of the event in the following format: Name of building, Street address, City, State, Zip Code
Your answer
Expected Attendance
Please provide an estimate of the number of individuals who would be attending the event.
Your answer
Attendee Profile
Please describe the targeted audience at the event (e.g. 16-18 year old young adults from the Vacaville Boys and Girls Club).
Your answer
Organization Name
Please provide the name of the requesting organization.
Your answer
Request Details
Please explain the specifics of the services and/or resources requested (seminar name, quantity of materials, reason for the request, etc.)
Your answer
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