Dane County Partnership Application Form
If your school or organization is new to partnering with MRP please use this form to apply to receive our programs and services. To partner with MRP your school or organization must be located and operate within Dane County and provide services/education to children and youth ages birth to 18 or their parents/caregivers. MRP serves children and youth attending all public schools in Dane County through existing partnerships and programs. If you represent a public school in Dane County, please email programming@madisonreadingproject.com for more information.
Name of School, Group or Organization
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If you represent a public school in Dane County, please email programming@madisonreadingproject.com for more information.
If you represent a program/department/service within the above organization please list it here and complete the remainder for the specific program/department/service you list below.
Does your school/organization/group operate within and serve families in Dane County?
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YES
NO
Does your school/organization/group serve young readers age birth to 18 or their caregivers?:
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YES
NO
What type of school, group, or organization do you represent?
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Birth to 5 Childcare Center/Home Based
School Based Youth Group/Organization
Private 4K-12th grade school
Non Profit Organization
Clinic, Hospital, Healthcare
Public Library/Government Program
Business/Corporate
Church or Faith Based School/Organization
Other
What is the mission or purpose of your school/organization?
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Contact Name
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First Name
Last Name
Contact Email Address
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example@example.com
Contact Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Website Link
e.g. madisonreadingproject.com
Needs Assessment
Please tell us more about the population your school/organization serves.
Please check all that apply for those served by your school/organization/group:
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Demonstrate high financial need
Historically underserved communities
What percentage of the population served by your school/organization/group are experiencing low income/financial circumstances that make access to new books challenging?
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0-25%
25-50%
50-75%
75-100%
Describe the financial challenges faced by the population you serve and how they impact access to resources such as books.
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Does your school/organization/group serve historically marginalized communities?
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Yes
No
Unsure
If yes, please tell us more about the communities you serve. Details are appreciated.
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Who would be impacted by a partnership with MRP?
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Children age birth-5 years old
Children Kindergarten-8th
High School Age Youth
Families/Parents/Caregivers
Educators (teachers, childcare providors, out of school time staff, social workers, etc.)
How will receiving free books benefit the population you serve? Please share a brief statement on the anticipated impact.
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Is there any additional information you would like to share with us?
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We genuinely wish we could honor every request received. However, due to capacity constraints, we must prioritize based on the criteria outlined above to ensure we reach those in greatest need first. We appreciate your understanding and are grateful for your commitment to making literature accessible to all.
Partner Agreement: Non-Discrimination Policy
By submitting this request, our organization agrees to uphold and actively practice a policy of non-discrimination. We affirm that we do not and will not discriminate in the delivery of services, selection of participants, or any aspect of this partnership based on: race, color, religion, national origin, ancestry, ethnicity, age, disability, sex, sexual orientation, gender identity or expression, marital status, military status, or any other characteristic protected by law. We are committed to fostering inclusive, respectful, and equitable environments for all children, educators, and communities served. We understand that: This policy is central to the mission and values of Madison Reading Project AND any verified violations of this agreement may result in review and potential suspension or termination of potential partnership and access to program resources.
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I have read and agree to the Non-Discrimination Policy as stated above
I understand the consequences of violating this agreement.
Signature
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