Prospective Community Partner Inquiry Form
This form is for prospective NEW partners who are interested in providing programming to students in collaboration with MPS. If you have partnered with MPS in the past and want to add a new program, please contact cpo@mpls.k12.mn.us. Thank you for your interest in partnering with Minneapolis Public Schools. If your program is a good fit or if we need more information, we will contact you with next steps. The inquiry, vetting, and processing can take 3-4 weeks after the initial inquiry review.
Data Privacy Notice
Minneapolis Public Schools (MPS) is asking you to provide information which includes private information. MPS will use this information to decide whether to certify you as a Community Partner. You are not legally required to provide the information requested, but if you do not complete the application form you will not be able to become a Certified Community Partner. The information you provide will be accessible to MPS employees whose jobs require them to access the information. It will be accessible to others outside of MPS only if you consent to the release of the information, or if there is a law (federal or state) or a court order that requires the information to be released.
I have read and understand the Data Privacy Notice
Organization Information
Please include all contact information, in case we have additional questions.
Have you had a community partnership agreement with MPS in the past?
*
Yes
No
Unsure
Name of Organization
*
Name of Program
Your Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Conflict of Interest Disclosure
A perceived or actual conflict of interest exists when commitments and obligations are compromised by other personal interests, or relationships, particularly if those interests or commitments are not disclosed.
Please list any potential conflicts of interest.
*
Potential conflicts of interest include: you are a current MPS employee, an MPS employee on your Board of Directors, personal relationship with MPS employee at site where your program will take place. Please review MPS Policy 3000 for further information: https://mps.municipalcodeonline.com/book?type=policies#name=Policy_3000:_Conflicts_Of_Interest_And_Fiduciary_Duty
Program Information
Please provide information about your program.
Did an MPS staff member ask you to complete this form to formalize a partnership agreement?
*
Yes
No
If yes, which school or department?
Name of the MPS staff member you have been communicating with about this program
Will you be requesting access to student data?
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Yes - will need aggregate/summary student data
Yes - will need individual student data
No
Not sure
Will MPS be paying you for this program?
*
No - there is no charge to school/District
Yes - there will be a fee per session/program
Both - combination of in-kind and fee-based
If this program is fee-based, what is the cost?
Who are your programs for?
Students
Families
Other
What grade levels does your program serve?
Early Childhood: Pre-K
Elementary School: K-5
Middle School: 6-8
High School: 9-12
Will this programming/service take place at a school/MPS site?
*
Yes - programming will take place at a school
No - programming will not take place at a school
When will you run your program?
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Before or after school
During the school day
Nights or weekends
Summer
Please share additional information about your program:
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Include audience, description of program, class period/time of day, number of days a week, etc.
What are the expected outcomes?
What will students be able to do differently as a result of this service/program? What are the learning targets?
How will the program be evaluated?
How will you know the program achieved the intended outcomes? Is there an external evaluation? Will the school do an evaluation?
If you have curriculum, additional program information, or a menu of services, please attach here.
Browse Files
Drag and drop files here
Choose a file
All curriculum is reviewed by subject matter experts, to ensure alignment with MPS needs.
Cancel
of
If you have curriculum, additional program information, or a menu of services, please attach here.
Browse Files
Drag and drop files here
Choose a file
All curriculum is reviewed by subject matter experts, to ensure alignment with MPS needs.
Cancel
of
When do you anticipate program/service will begin?
-
Month
-
Day
Year
Date
When do you anticipate program will end?
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Month
-
Day
Year
Date
Requirements and Expectations
MPS requires contracted community partners to agree to MPS Community Partnership Expectations and maintain a minimum level of liability insurance as outlined here: https://www.mpschools.org/community/community-partners/mps-certified-community-partner-criteriaexpectations
Can you meet our insurance requirements? (Link above)
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Yes
No
I have questions about the insurance requirements
I have read and agree to follow all MPS Community Partnership Expectations (link above). I understand that completing this form is the first step to becoming an authorized community partner and that I still need to complete a contract for any work that I conduct in partnership with MPS.
*
Yes - I agree
No - I do not agree
I have some questions about this. Please contact me to discuss.
Do you have any questions?
Feel free to ask any questions about this process or partnerships. We will respond within 5 business days.
That's It!
The External Relations Department will get an email that you have submitted this form. New forms are reviewed and processed on a recurring basis.
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