PERMANENT LEASING REQUEST FORM
Thank you for your interest in partnering with Life Remodeled at our new opportunity hub, Anchor Detroit! Please complete this application to share more with us about your organization.
ORGANIZATION INFORMATION
What is the name of your organization?
*
Is this a nonprofit organization
*
Organization Website
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
LEAD CONTACT INFORMATION
Name
*
First Name
Last Name
Role/Job Title
*
Phone Number
*
Please enter a valid phone number.
Email Address
*
example@example.com
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PROGRAM INFORMATION
What are the impact areas of your program? (Check all that apply.)
*
Youth Programming
Health & Wellness
Community Resources
Workforce Development
Tech
Arts & Culture
Other
Please provide us with a brief description of your program.
*
How many unique individuals does your program intend to serve once you are at full capacity?
*
How many employees do you plan to have once you are at full capacity
*
Is there a cost to participate in this program?
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Yes
No
When would your organization like to start programming at our opportunity hub?
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Summer 2025
Fall 2025
Winter 2025
Desired Commencement Start Date
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Month
-
Day
Year
Date
Please upload any additional documents about your organization/program for our consideration (program overview, flyers, etc.).
Browse Files
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Choose a file
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SPACE ACCOMMODATIONS
What is your desired square footage ?
*
600-700
700-900
1000+
Submit
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