GWJ$ Partner Application Survey

*
1. Your Contact Information

Your Contact Information Primary Contact Name:
Name of Organization:
Title
Address
City/Town:
State:
ZIP:
Website:
Email Address:
Phone Number:

*
2. Organizational Structure:

Organizational Structure: Not-for-profit (e.g. 501(c)3, trade groups, associations, foundations, etc.)

For-profit

Federal agency or department

Educational Institution

Individual

Other (please specify)

3. If you have an alternate contact at your organization, please provide their information below:

If you have an alternate contact at your organization, please provide their information below: Contact Name:
Title:
Phone Number:
Email:

4. MISSION of organization or financial literacy department

MISSION of organization or financial literacy department

5. Description of Financial Literacy Activities, Programs and/or Services

Description of Financial Literacy Activities, Programs and/or Services

6. Target Audience:

Target Audience: Elementary School (K-5)

Middle School (6-8)

High School (9-12)

K-12

College

Other (please specify)

7. What are the principal activities of your organization in Greater Washington? Please select all that apply:

What are the principal activities of your organization in Greater Washington? Please select all that apply: Teacher Training Volunteer Training Classroom Presentations Financial Literacy Classes (throughout school year)	Counseling/Mentoring Publishing Extracurricular Financial Literacy Programs Curriculum Development	Fundraising Grant-making / Sponsorship
Other (please specify)

8. Please describe any specific NEEDS your organization has(e.g. volunteers, partnerships, curricula, access, funding, etc.)

Please describe any specific NEEDS your organization has(e.g. volunteers, partnerships, curricula, access, funding, etc.)

9. It is our vision that one day all Greater Washington students have personal finance in their education. Greater Washington Jump$tart provides the communication, coordination and collaboration necessary to ensure this education. But our success relies on strong community partnerships, committed volunteers and grassroots leadership. What ways can you and your organization actively engage with Greater Washington Jump$tart to help us achieve our collective goals? (Please select all that apply and describe below)

It is our vision that one day all Greater Washington students have personal finance in their education. Greater Washington Jump$tart provides the communication, coordination and collaboration necessary to ensure this education. But our success relies on strong community partnerships, committed volunteers and grassroots leadership. What ways can you and your organization actively engage with Greater Washington Jump$tart to help us achieve our collective goals? (Please select all that apply and describe below) Volunteers Donations Sponsorships Committee Membership Event space Website Development	Graphic Design Public Relations / Media Engagement Partner Recruitment Referrals Public Speaking Research	Strategic Planning Teacher Training Event Subcommittee Financial Literacy Breakfast Subcommittee Partner Meeting Subcommittee In-Kind Services Other
Please describe:

10. Do you know other organizations/individuals involved in financial literacy in the region who would benefit by getting involved with Greater Washington Jump$tart? If yes, please list the contact's name, organization, email, and phone number:

Do you know other organizations/individuals involved in financial literacy in the region who would benefit by getting involved with Greater Washington Jump$tart? If yes, please list the contact's name, organization, email, and phone number:

*
11. May we share your contact information with other Greater Washington Jump$tart partners?

May we share your contact information with other Greater Washington Jump$tart partners? YES

NO

*
12. How do you plan to pay your annual partner dues?

How do you plan to pay your annual partner dues? Cash

Check

Online Payment

Other (please specify)

GWJ$ Partner Application

1. GWJ$ Partner Application

*1. Your Contact Information

*2. Organizational Structure:

3. If you have an alternate contact at your organization, please provide their information below:

4. MISSION of organization or financial literacy department

5. Description of Financial Literacy Activities, Programs and/or Services

6. Target Audience:

7. What are the principal activities of your organization in Greater Washington? Please select all that apply:

8. Please describe any specific NEEDS your organization has(e.g. volunteers, partnerships, curricula, access, funding, etc.)

10. Do you know other organizations/individuals involved in financial literacy in the region who would benefit by getting involved with Greater Washington Jump$tart? If yes, please list the contact's name, organization, email, and phone number:

*11. May we share your contact information with other Greater Washington Jump$tart partners?

*12. How do you plan to pay your annual partner dues?

*
1. Your Contact Information

*
2. Organizational Structure:

*
11. May we share your contact information with other Greater Washington Jump$tart partners?

*
12. How do you plan to pay your annual partner dues?