Millington Lunch & Learn™ – Partner & Speaker Interest Form
Contact Information
Name
*
Organization (if applicable)
Phone Number
*
Email
example@example.com
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Please submit a logo and a photo of you
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Which month are you available?
Type the months you available to speaker/sponsor. Conversations are usually held on the 3rd Friday or Saturday, unless otherwise posted.
How would you like to participate?
Select all that apply
Speaker / Facilitator
Community Partner
Sponsor or Resource Partner
Not sure - open to conversation
Area of Focus
Check all that apply
*
Civic engagement
Youth leadership
Health & Wellness
Education
Economic Opportunity
Housing & Community Development
Veteran or military support
Other
If you checked "other" please explain
Lived experience & perspective
Briefly share what perspective or experience you would bring to the Millington Lunch & Learn™ conversation.
Community Connection
Do you live, work, or serve in Millington or the surrounding area?
Yes
No
If yes, please briefly describe your connection
Values Alignment
Anything else you would like us to know?
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Should be Empty: