Luminara Prep™ Verified Business Partner Application

Luminara Prep™ Verified Business Partner Application

Submit your business details and documentation for private review—approval and eligibility are not guaranteed.
Business Identity
Legal business name
Public-facing brand / DBA
Business type
Year established
Business registration jurisdiction
Registration / entity / trade name number
Website / portfolio URL
Public business social pages
Business phone
Please enter a valid phone number.Format: (000) 000-0000.
Business email
example@example.com
Business city, state, ZIP

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Service area
Responsible owner / authorized representative full name

First NameMiddle NameLast Name
Professional role
Representative email
example@example.com
Authorized representative can bind the business to terms
Business verification document

Cancelof
Partner Track
Partner track(s)
Service title(s)
Service description(s)
Primary subject areas

Other
Age range served

Other
Delivery format
Approximate price or price range
Arizona service city or area
Typical session length
Typical schedule or availability
What makes your services unique?
Portfolio link
Educator bio or organization description
Educational credentials, certifications, and optional professional links
Sample program overview, course syllabus, or activity plan

Cancelof
Quality images or logo (permission-cleared, business-owned media only)

Cancelof
Accommodation and inclusion details (AAC, sensory-friendly supports, developmental disability inclusion, neurodiversity accessibility, language(s), parental involvement; N/A permitted)
If offering in-person trips, sports, or other supervised activities: supervision ratio, pickup and safety plan, emergency protocol, and facility licensing details where applicable
Safety, Eligibility, and Business Review
Do any instructors or staff have direct contact with children?
Names and roles of adult child-facing instructors or staff
Pre-teaching verification confirmation
Arizona IVP or fingerprint clearance status, if applicable
Safeguarding or mandatory reporting policy document, if available

Cancelof
Safeguarding or mandatory reporting policy link, if available
Online instruction safeguards

Other
Insurance status
Professional licenses and expiration dates, where applicable
Currently independently authorized to accept Arizona ESA / ClassWallet funding?
Optional details or proof regarding Arizona ESA / ClassWallet authorization
Previous customer reviews, references, public profile link, and past business work
Terms and Signature
Partner Application Terms
Acknowledgment of Terms
Authorization and Accuracy Certification
Electronic Signature

First NameLast Name
Signature Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Applicant Comments
Should be Empty:

Luminara Prep™ Verified Business Partner Application

Business Identity

Partner Track

Safety, Eligibility, and Business Review

Terms and Signature