TCPS New Partner Profile Survey

1.Organization's official name.
(The official name as used on your official correspondence, websites, etc.)(Required.)

2.If your organization is a system and partnership will cover more than one facility or school (program of study), list the facilities/programs of study below.

3.Organization's address and contact information:(Required.)

Street Address:

City/Town:

State:

ZIP/Postal Code:

Area Code & Phone Number

Area Code & Fax Number:

4.Your County if in Tennessee

5.Which TCPS Region(s) would be most appropriate for you to join? Each region is centered at a metropolitan hub and extends outward. More rural areas may request multiple regional partnerships if needed based upon historical student/facility interaction.(Required.)

6.Type of Partner Organization:(Required.)

School

Clinical Facility

TCPS New Partner Profile

3.Partner Profile