Promise Partnership Request Question Title * 1. Get Started: Name: * Organization/Department: * Phone: * Email: * Address, City * State -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP: Best time to Contact Question Title * 2. Does your partnership project have existing connections/relationships with a particular Promise South Salt Lake Neighborhood Center of staff member? If yes, which one(s)? Question Title * 3. Do you already have a Promise South Salt Lake Neighborhood Center in mind as a fit for this partnership project? If yes, have you worked with this center in the past? Question Title * 4. What are the dates that you're interested in having an interaction with us? Question Title * 5. Are these dates flexible? Yes No Other (please specify) Question Title * 6. Are you looking to fit within a specific time frame? Specific month Semester Academic Year May Term Other (please specify) Question Title * 7. With what frequency are you looking to partner? Weekly 2-3 times per month Monthly Semester Annually Question Title * 8. Please type the number of Westminster students you are involved with on this project: Question Title * 9. Is there a particular community group you are interested in working with? Elementary Youth Junior High Youth High School Youth Adults Community Members Seniors International Artists Families Women Other (please specify) Question Title * 10. Is there a specific location/setting you are interested in partnering? Neighborhood Center Community Based Setting School Setting Community Event Promise Leadership Council Other (please specify) Question Title * 11. Which of the following describes your interest in partnering with Promise South Salt Lake? Service Project Research Practical experience in discipline Provide interest-based or experiential learning opportunities Recreation Academic Support Tutors Mentors Offer Services Offer Supplies If academic, services or supplies answered above, please specify what type here: Question Title * 12. Do you have a partnership project in mind? If so, in 20 words or less, give a project description/overview: Done
