Long-term Partnerships Form

Full Name*

Email*

Phone*

Where are you from?*

(City, Province)

Are you a part of a...*

If you selected "other" please specify

Name of your Company/NPO/School*

Description of your Company/NPO/School*

Description of your Partnership/Programming idea or requestion*

Please provide program location, if known.

Do you currently have funding for this idea or request?*

What are you able to contribute to partnership opportunity?*

If you selected "other" please specify

Projected Start Date*

Projected Duration*

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