PRC in Massachusetts Partner Application

Team Contact Information

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* 1. Lead Org Contact Information

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 2. Project Lead Name

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* 3. Project Lead Email

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* 4. Please download and complete the attached Organizational Contact Information Sheet with the requested information about the lead organization and key partners for this project.

Upload the completed Organizational Contact Information Sheet (linked above)

PDF, DOC, DOCX file types only.

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* 5. Are the key leaders and decision-makers in your organization People of Color? Yes or No.

Yes

No

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* 6. If yes, please share the names and positions of your organization’s leadership below (ex. Directors of communications, finance, executive leadership, board members etc.).