Partnership Application Partnership ApplicationName of OrganizationContact InformationWho will be coordinating bag requests and pick-ups?Organization NameFirst NameLast NameTitleEmail AddressPhone/MobileAddressStreetCityStateZip CodeWhat county is your organization in? (list all counties or state-wide if needed)Type of Organization (check all that apply) 501 (c) 3 nonprofit Church Government Agency Other (please list)IRS Determination Letter (required for 501(c) 3 organizations)Choose File Other Type of OrganizationOrganization Website URLFacebook URL (leave blank if you do not have one)Instagram URL (leave blank if you do not have one)TikTok Handle (leave blank if you do not have one)Mission of Your OrganizationDescribe the Population That Your Organization ServesRacial/Ethnicity Information of Those You Serve (percentages if possible)Service Area (counties)How Many Children, Ages 0-18 yrs Old, Does Your Organization Serve Each Year?What Are the Eligibility Requirements for Clients to Receive Services with Your Organization?Does Your Organization Track Clients? If So, How?How Would Your Organization Distribute Bags?Does Your Organization Accept Walk-in Requests for Bags from the Public? Yes No OtherHow Many of the Children You Serve, Will Need Bags Each Month from Adventure Bags, Inc.?Are there additional ways your organization can help support us? (Please use this space if you have creative, additional, or fun ideas to solidify our partnership together.) This space is for you to tell us anything else that you think we should know. List 3 Agencies You Already Partner With Agency Name Contact Name Phone # Email Address NOTE: Please view the following link for our Memorandum of Understanding and complete the following to let us know that you read, agree and would like to proceed. To become a partner with Adventure Bags, you must provide us with a signature below for the Memorandum of Understanding document. View Memorandum of UnderstandingSignatureSignature DateSubmit Form
