Community Based Learning Partner Intake Form
Supporting Project Driven Community & EMU University Collaboration
Name of person filling out this form
First Name
Last Name
Organization/Program Name
Email
example@example.com
Please describe your organizational/programmatic need or project.
What is your project timeline?
A semester (15 weeks)
An academic year (2 semesters)
Half a semester or less
Other
What is your desired project deliverable?
Marketing or PR
Graphic Design Work
Application (APP) Development
Technical or other Writing Support
Social Media and Other Communication Support
Event visioning and/or management
Direct on-site services (e.g. mentoring, counseling, etc.)
Curriculum Design
Survey Design and Implementation
Mapping
Other
Submit
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