Thank you for your interest in connecting with Wittenberg University’s Hagen Center for Civic and Urban Engagement! Please complete all required fields to help us learn more about your organization and your interest in partnering with us.

Question Title

* 1. Name

Question Title

* 3. Phone Number

Question Title

* 4. Organization

Question Title

* 5. What is your role with this organization?

Question Title

* 6. Description of Organization (include mission)

Question Title

* 7. Organization Website

Question Title

* 8. Desired Partnership Details (How would your organization like to partner with the Hagen Center?)

Question Title

* 9. Does your organization currently have a connection to the Hagen Center or to other departments at Wittenberg University?

Question Title

* 10. How did you find out about the Hagen Center at Wittenberg University? (only required if you are not already in partnership with the Hagen Center)

Question Title

* 11. Please provide additional information that would be helpful for our staff to understand your partnership interests.

T