Partnership Request Form
Share your organization details, program interests, and scheduling preferences so we can review your request.
Organization Information
Organization/School Name
*
Organization Type
*
Please Select
Public School
Private School
Charter School
Preschool/Daycare
College/University
Nonprofit Organization
Church/Faith-Based Organization
Business
Community Center
Government Agency
Other
Primary Contact Name
*
First Name
Middle Name
Last Name
Job Title
*
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Organization Website
Organization Address
*
City
*
State
*
ZIP Code
*
Program Details
Type of Partnership
*
Please Select
One-Time Workshop
Weekly Program
Monthly Program
School-Day Enrichment
After-School Program
Summer Program
Special Event
Family Engagement Night
Other
Expected Number of Participants
*
Please Select
10–25
26–50
51–100
101+
Age/Grade Levels Served
Pre-K
Kindergarten–2nd Grade
3rd–5th Grade
6th–8th Grade
9th–12th Grade
College
Adults
Families
Scheduling
Preferred Start Date
*
-
Month
-
Day
Year
Date
Preferred End Date
-
Month
-
Day
Year
Date
Preferred Day(s)
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Preferred Time(s)
*
Morning
Afternoon
Evening
Session Length
*
Please Select
30 Minutes
45 Minutes
60 Minutes
90 Minutes
2 Hours
Custom
Location
Where should the program take place?
*
We would like MEE to travel to our location
We would like to bring participants to the MEE Studio at the Jackson Medical Mall
Either option works
If MEE travels to you, what is the program location?
Funding
How will the partnership be funded?
*
Organization Budget
Grant Funding
Sponsorship
Parent Fees
Fundraising
Unsure
Other
Is funding currently available?
*
Yes
No
Pending
Additional Information
Describe your organization and what you hope to accomplish through this partnership
*
Is there anything else you would like MEE to know?
Authorization
Name
*
First Name
Last Name
Title
*
Digital Signature
*
Date
*
-
Month
-
Day
Year
Date
Submit Request
Submit Request
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