UNIVERSE KONADU Artistpreneur™ Academy for Emerging Leaders
Host Partner Agreement - L.adies I.ndependently T.hriving
Organization Information
Name of Organization
*
Name of Person Completing Form (first & last name, include title)
*
Entity Type
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Please Select
Non profit
For profit
Please check all that apply to your organization
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Has a current copy of its Certificate of Liability Insurance
Worked with Professional Service Providers in the past
Maintains operating hours that do not exceed 6:30pm
Serves youth
Offers transportation to program participants
Has a physical office location
Offers intervention & preventative services
Has Criminal Background Check on file for youth coordinators
Has Criminal Background Check on file for office staff
Please provide a current copy of your Certificate of Liability Insurance
*
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Organization's Physical Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Organization's Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Main Office Number
*
Format: (000) 000-0000.
Point of Contact (first & last name, include title)
*
Point of Contact Office Number
*
Format: (000) 000-0000.
Extension
Point of Contact Mobile Number
*
Format: (000) 000-0000.
Point of Contact Email
*
example@example.com
Name of Program Being Hosted
*
Anticipated Start Date & Time
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Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Alternate Anticipated Start Date & Time
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Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Anticipated End Date & Time
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-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
How will the youth benefit from this program?
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How will the host organization benefit from this program?
*
Program recruitment is scheduled to start Jan. 2025. Click 'yes' below to confirm.
*
Yes
Program is scheduled to run once (1) weekly, three (3) program hours per day. Click 'yes' below to confirm.
*
Yes
Below are the proposed Open Interview Dates for potential program participants. Click 'check all' to confirm.
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Feb. 5, 2025
Feb. 6, 2025
Feb. 7, 2025
Below are the proposed Alternate Open Interview Dates for potential program participants. Click 'check all' to confirm.
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Feb. 9, 2025
Feb. 11, 2025
Feb. 12, 2025
Host Partner agrees to provide the following:
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Host Location & Program Space
Recruitment
Marketing & Promotions (all final M&P materials MUST be approved by UNIVERSE KONADU rep.)
Panel Evaluators (Youth Employers) for Pitch Presentations
Additional Comments and Information
Universe Konadu Artistpreneur™ Academy for Emerging Leaders is a prestigious association offering an innovative collegiate arts-in-business curriculum specially designed to enrich the lives of high school girls ages 14-18 with a strong interest in, and passion for, arts and entrepreneurship. With tiered courses providing engaging and practical activities, girls develop leadership skills that empower them to make more informed life choices. Emerging Leaders set clear goals to graduate high school, continue on to post-secondary education opportunities, start their own businesses and live independently. By clicking 'yes' below, I agree that I am an authorized representative of the above named organization and as a Host Partner of Universe Konadu Artistpreneur™ Academy for Emerging Leaders accept all of the above terms stated in this agreement, and hereby release UNIVERSE KONADU and its legal representatives and assigns from all claims and liability relating to said program.
*
Yes
Signature
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