Faculty Request for Partnership
*Please, note that new partners are typically vetted in the summer*

Your Information & Agency Information

1.Please enter your:(Required.)
2.Name of agency
3.Enter the following information for the agency contact:(Required.)
4.Have you had any contact with this person?(Required.)
5.Which of the following applies to the agency?(Required.)
6.Does this agency have liability insurance that covers on-site volunteers?(Required.)
7.Does the agency have any full-time, paid staff? If so, how many?
8.Give a brief summary of the mission of the agency.