Rehabilitation Through the Arts

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* 1. First name:

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* 2. Last name:

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* 3. Email address:

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* 4. Contact number:

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* 5. HBS degree and year:

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* 6. Address:

Address:

Address 2:

City/Town:

State:

ZIP:

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* 7. Nonprofit interest area:

Arts & Culture

Education

Environment & Health

Social Services

Other (please specify)

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* 8. Type of project that interests you:

Consulting (10-15 hours per month for 3 to 4 months)

Brainstorming (2-3 hours for 2 to 3 sessions)

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* 9. Would you be interested in being a team leader?

Yes

Maybe

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* 10. Available hours per month:

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* 11. Industry:

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* 12. Company:

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* 13. Your title:

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* 14. How did you hear about Community Partners? Please include specifics in the box below.

HBSCNY Community Partners website

HBS alumni referral (please specify)

Web search

Previous Community Partners engagement (please specify)

HBSCNY program/event (please specify)

General email announcement (please specify)

Facebook

Other

Other (please specify)

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* 15. Why are you interested in volunteering with Community Partners?

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* 16. List any previous Community Partners or consulting project experience:

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* 17. Additional comments:

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* 18. If you are not a member of HBS Club of New York or an HBS Affinity Club, please consider joining to help support programs like Community Partners. Visit www.hbscny.org and click on the "Membership" tab for information.